Introduction

Sperm acquisition is often used as a primary end point in reporting outcomes from mTESE in men with NOA. The aim of this study was to report live birth rates following mTESE and analyse factors affecting outcome.

Methods

A retrospective review of patients undergoing a primary mTESE for NOA by a single surgeon was conducted, reporting on outcomes from the first cycle of ICSI.  The primary outcome measures were pregnancy (PR) and live birth rates (LBR).

Results

A total of 230 patients were included. The mean age of male and female patients was 42.8 and 33.4 respectively.  Sperm was retrieved in 105 of 230 (45.7%) of men. 83 patients had ICSI cycles. The mean number of embryos implanted was 1.8 and pregnancy rate was 43.8%, with a primary LBR of 17.3%. 28 (33.7%) of patients had a further 43 ICSI cycles performed with a cumulative live birth rate of 23.3%. There was no significant difference in pregnancy (p = 0.37) or live birth (p = 0.82) rates between fresh and frozen sperm. Age of male or female partners, Johnsen score or histology did not predict success. In 4 (4.8%) patients sperm was non-viable on the day of egg retrieval.

Conclusion

Sperm can be retrieved in 46% of all men with NOA, although only 17.3% are able to achieve paternity at first cycle, which is independent of the histological diagnosis. There is no difference in outcomes between fresh and frozen sperm, although in a small number, sperm won't survive cryopreservation.