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Does acquired obstructive azoospermia have less impact than congenital azoospermia on ICSI results? Systematic review and meta‐analysis
Author(s) -
Lopes Leonardo Seligra,
Baccaglini Willy,
von Muhlen Bruno,
Placco Araujo Glina Felipe,
Albertini Daiuto Sergio,
Linck Pazeto Cristiano,
Glina Sidney
Publication year - 2021
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.14096
Subject(s) - azoospermia , obstructive azoospermia , medicine , vasectomy , pregnancy rate , gynecology , live birth , pregnancy , andrology , obstetrics , infertility , population , biology , family planning , research methodology , genetics , environmental health
Abstract An electronic‐based search was performed with MEDLINE bases through PubMed, Cochrane through Central, and Embase until August 2020 for the purpose of evaluating the impact of the aetiology of obstructive azoospermia on ICSI cycles. In the final analysis, there were 15 cohort studies included, comparing a group of patients with acquired azoospermia and others due to congenital bilateral absence of the vas deferens submitted to ICSI. Those 15 articles within 4,480 couples were analysed, and similar fertilisation rate (65.1% vs. 65.3%; p = .38), pregnancy rate per cycle (40.0% vs. 43.1%; p = .06) and live birth rate (29.6% vs. 30.0%; p = .76) were found between groups. Comparing specifically post‐vasectomy azoospermia and congenital groups, both presented a similar fertilisation rate (62.4% vs. 53.4%, respectively; OR 1.10; 95% CI, 0.79, 1.54; p = .56; I 2 = 89%) and pregnancy rate per cycle (39.4% vs. 35.6%, respectively; OR 1.26; 95% CI, 0.96, 1.66; p = .09; I 2 = 0%). However, a higher live birth rate was identified in the congenital group compared to vasectomy group (28.4% × 19.5%; OR 1.54; 95% CI, 1.11, 2.15; p = .01; I 2 = 0%). The reasons for that are unclear and factors such as couple age and sperm DNA fragmentation should be considered.