scholarly journals Effect of Granulocyte Colony Stimulating Factor (GCSF) on Live Birth Rate in Women With Unexplained Infertility After Intrauterine Insemination: a Randomized Clinical Trial

2020 ◽  
Author(s):  
Shahintaj Aramesh ◽  
Maryam Azizi Kutenaee ◽  
Fataneh Najafi ◽  
Parvin Ghaffari ◽  
Seyed Abdolvahab Taghavi
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Unexplained Infertility ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Granulocyte Colony Stimulating Factor ◽  
Biochemical Pregnancy ◽  
Significant Difference ◽  
Stimulating Factor

Abstract Background: to evaluate the effect of granulocyte colony stimulating factor (GCSF) on fertility outcomes in women with unexplained infertility after intra uterine insemination (IUI).Methods: The patients with unexplained infertility were divided into two groups: one group was received GCSF in their IUI cycle and the other group had the routine IUI. Both groups were stimulated by letrozole, metformin and monotropin during the cycle. When at least one follicle was greater than 18mm, 5000 IU hCG intramuscularly was administered for ovulation induction and IUI was performed 34-36 hours later. In intervention group, 300 ug GCSF subcutaneously administrated in two days after IUI. The main outcome measures were biochemical pregnancy, clinical pregnancy, abortion rate and live birth rate.Results: There was no significant difference in demographic and clinical characteristics between the control group and the G-CSF group. Also, no statistically significant difference was identified in the biochemical pregnancy rates (16.3% vs 12.2%), clinical pregnancy rates(16.3% vs 8.2%), abortion rates (0 vs 2.04%) and live birth rates (8.2% vs 14.2%) between the control group and the G-CSF group (P=0.56, P=0.21, p=0.55 and p=0.32 respectively). Conclusion: Systemic administration of a single dose of 300 μg GCSF subcutaneously two days after IUI may slightly improve clinical pregnancy rate and live birth rate in patients with unexplained infertility. Nevertheless, our findings do not support routine use of G-CSF in unexplained infertility women with normal endometrial thickness. IRCT registration number: IRCT20160524028038N4.

scholarly journals Comparison of Frozen Embryo Transfer Outcomes Between Uterine Infusion of Granulocyte Colony-Stimulating Factor and Growth Hormone Application in Patients With Thin Endometrium: A Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Jiang ◽  
Xin Xu ◽  
Ziyu Cao ◽  
Ni Yang ◽  
Shaoqing Wang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Birth Rate ◽  
Endometrial Thickness ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Granulocyte Colony Stimulating Factor ◽  
Thin Endometrium ◽  
Biochemical Pregnancy ◽  
Significant Difference ◽  
Stimulating Factor

ObjectiveTo investigate the effect of two treatments on the outcome of freeze-thaw embryo transfer for pregnancy assistance in thin endometrium.MethodsA retrospective study was conducted on 66 patients who failed in the first cycle treated in the reproductive medicine center of the Second Hospital of Hebei Medical University from January 2018 to December 2019. Granulocyte colony stimulating factor (G-CSF) was used through cavity infusion in one group (n=25, and growth hormone (GH) was subcutaneously injected in the group (n=41). The clinical data of the two groups were compared, including morphology and thickness of the endometrium, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, miscarriage rate, and live birth rate in each period of the hormone replacement cycle.ResultsThere was no significant difference in age, BMI, AMH, FSH, LH, E2, infertility years, number of transferred embryos, basal endometrium, and thickness of endometrium on the day of P administration before and after treatment (P> 0.05). After treatment, compared to the GH group, the G-CSF group presented higher biochemical pregnancy rate (56% versus 48.8%; P=0.569), clinical pregnancy rate (52% versus 46.3%; P=0.655), implantation rate (34.8% versus 27.5%; P=0.391), and live birth rate (40% versus 31.7%; P=0.493), but the differences were not statistically significant (P > 0.05). On the 5th day of treatment, the endometrial thickness in the G-CSF group was thinner than that in the GH group (4.83 ± 0.85 versus 5.75 ± 1.27; P< 0.05), but it had no correlation with pregnancy outcome (P > 0.05). There was no significant difference in endometrial thickness between the two groups on the 7th, 9th day of treatment and the day of P administration (P > 0.05). On the 5th day of treatment, the proportion of endometrial type A morphology in the GH group was significantly higher than that in the G-CSF group (P < 0.05), while the type B morphology in the G-CSF group was significantly higher than that in the GH group (P< 0.05).ConclusionAlthough G-CSF and GH may not have a role in increasing endometrium, both of them can improve the pregnancy outcomes of patients with thin endometrium in the FET cycle. And the effects of the two treatments were similar.

scholarly journals Thyroid autoimmunity and IVF/ICSI outcomes in euthyroid women: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ashley Venables ◽  
Wilbert Wong ◽  
Mandy Way ◽  
Hayden Anthony Homer
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Meta Analysis ◽  
Thyroid Autoimmunity ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Miscarriage Rate ◽  
Biochemical Pregnancy ◽  
Significant Difference ◽  
Icsi Outcomes

Abstract Background Thyroid autoimmunity (TAI) – the presence of anti-thyroid peroxidase and/or anti-thyroglobulin antibodies – affects 8–14% of reproductively-aged women. It is hotly debated whether TAI adversely affects IVF/ICSI outcomes. This systematic review and meta-analysis evaluated the relationship between thyroid autoimmunity (TAI) and IVF/ICSI outcomes, both overall and amongst euthyroid women of known age using strict criteria for grouping pregnancy outcomes. Methods The review was registered with PROSPERO: CRD42019120947. Searches were undertaken in MEDLINE, EMBASE, Web of Science and Cochrane Database from Inception-March 2020. Primary outcomes were clinical pregnancy rate, clinical miscarriage rate, biochemical pregnancy loss, livebirth rate per-cycle and live birth rate per clinical pregnancy (CP). Results 14 studies were included in the meta-analysis. Compared with women who tested negative for thyroid autoantibodies (TAI-), there was no significant difference in clinical pregnancy rate overall (OR 0.86; 95%CI [0.70, 1.05]; P = 0.14; 11 studies; I2 = 29.0%), or in euthyroid women (OR 0.88; 95%CI [0.69, 1.12]; P = 0.29; 10 studies; I2 = 32.0%). There was also no significant difference in clinical miscarriage rate overall (OR 1.04; 95%CI [0.52, 2.07]; P = 0.908; 8 studies; I2 = 53%), or in euthyroid women (OR 1.18; 95%CI [0.52, 2.64]; P = 0.69; 7 studies; I2 = 54%). There was no significant difference in biochemical pregnancy loss (OR 1.14; 95%CI [0.48, 2.72]; P = 0.769; 4 studies; I2 = 0.0%), live birth rate per cycle (OR 0.84; 95%CI [0.67, 1.06]; P = 0.145; I2 = 1.7%), live birth rate per clinical pregnancy (OR 0.67; 95%CI [0.28, 1.60]; P = 0.369; I2 = 69.2%), both overall and in euthyroid women as all studies included consisted of euthyroid women only. There was also no significant difference in number of embryos transferred, number of oocytes retrieved, mean maternal age or TSH levels overall or in euthyroid women. Conclusion The findings of the present study suggest that thyroid autoimmunity has no effect on pregnancy outcomes in euthyroid women alone, or in euthyroid women and women with subclinical hypothyroidism.

scholarly journals Oocytes With Smooth Endoplasmic Reticulum Aggregates Are Not Associated With Impaired Reproductive Outcomes: A Matched Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jian Xu ◽  
Li Yang ◽  
Zhi-Heng Chen ◽  
Min-Na Yin ◽  
Juan Chen ◽  
...  
Keyword(s):  
Endoplasmic Reticulum ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Defects ◽  
Birth Rate ◽  
Smooth Endoplasmic Reticulum ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Reproductive Outcomes ◽  
Significant Difference

ObjectiveTo investigate whether the reproductive outcomes of oocytes with smooth endoplasmic reticulum aggregates (SERa) are impaired.MethodsA total of 2893 intracytoplasmic sperm injection (ICSI) cycles were performed between January 2010 and December 2019 in our center. In 43 transfer cycles, transferred embryos were totally derived from SERa+ oocytes. Each of the 43 cycles was matched with a separate control subject from SERa- patient of the same age ( ± 1 year), embryo condition, main causes of infertility, type of protocols used for fresh or frozen embryo transfer cycles. The clinical pregnancy, implantation, ectopic pregnancy and live birth rate were compared between the two groups.Results43 embryo transfer cycles from SERa- patient were matched to the 43 transferred cycles with pure SERa+ oocytes derived embryos. No significant difference was observed in clinical pregnancy rate (55.81% vs. 65.11%, p=0.5081), implantation rate (47.89% vs. 50.70%, p=0.8667) and live birth rate (48.84% vs. 55.81%, p=0.6659) between the SERa+ oocyte group and the matched group. No congenital birth defects were found in the two groups.ConclusionOur results suggest that the implantation, clinical pregnancy, live birth and birth defects rate of embryos derived from oocytes with SERa are not impaired.

scholarly journals Effect of intrauterine granulocyte-colony stimulating factor administration on in vitro fertilization outcome in women with moderate-to-severe endometriosis: An RCT

2021 ◽  
pp. 733-740
Author(s):  
Ladan Kashani ◽  
Ashraf Moini ◽  
Tayebeh Esfidani ◽  
Nazila Yamini ◽  
Shima Mohiti
Keyword(s):  
In Vitro Fertilization ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Vitro Fertilization ◽  
Infertile Women ◽  
Significant Difference ◽  
Stimulating Factor

Background: Nearly 25-50% of infertile women have endometriosis. There are reports of disorders in the expression of granulocyte colony-stimulating factor (G-CSF) receptors in women with endometriosis. Objective: To examine the effect of intrauterine administration of G-CSF in in vitro fertilization (IVF) cycles on the fertility rate of infertile women with moderate-to-severe endometriosis. Materials and Methods: This clinical trial was conducted on 66 infertile women with moderate-to-severe endometriosis, undergoing IVF and intracytoplasmic sperm injection (ICSI). The participants were allocated into two groups via simple randomization: the G-CSF (n = 27) and control (n = 39) groups. In the G-CSF intervention group, on the oocyte pick-up day, immediately after an ovarian puncture, 300 μg of G-CSF was injected through a transcervical catheter under abdominal ultrasound guide to visualize flushing into the uterine cavity. Women in the control group received no intervention. The two groups were evaluated for clinical pregnancy. Results: No significant difference was noted in the demographic characteristics of the two groups. The rate of clinical pregnancy was 28.2% in the control group and 25.9% in the G-CSF group, indicating no significant difference (p = 0.83). Conclusion: The results showed that the intrauterine injection of G-CSF had no effects on pregnancy in women with stage-3/4 endometriosis undergoing IVF. Key words: G-CSF, In vitro fertilization, Endometriosis, Pregnancy.

scholarly journals Randomized Controlled Study of the Effects of DHEA on the Outcome of IVF in Endometriosis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yanxia Zhang ◽  
Meiqing Li ◽  
Lian Li ◽  
Jianghua Xiao ◽  
Zhe Chen
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Synthesis Process ◽  
Controlled Study ◽  
Control Group

Objective. To investigate the effect of dehydroepiandrosterone (DHEA) on the outcome of in vitro fertilization (IVF) in patients with endometriosis (EMT). Methods. Female patients diagnosed with EMT in our hospital from May 2018 to May 2019 were selected. The patients were divided into the control group (n = 22) and the DHEA group (n = 22) according to the random number table. Patients in the control group received placebo and patients in the DHEA group received DHEA. Patients in both groups received either DHEA (25 mg) or placebo orally 3 times a day for 90 days from the first day of menstruation. Patients were subsequently treated with an IVF cycle. In the control group, 22 patients completed the first cycle and 13 patients completed the second cycle. In the DHEA group, 22 patients completed the first cycle and 11 patients completed the second cycle. Serum sex hormone levels including serum E2 on hCG day, mean progesterone on hCG day, FSH on day 2, AMH on day 2, and gonadotropin dose were determined using a chemiluminescent immunoassay kit. The number of antral follicles of the bilateral ovaries was counted by transvaginal B-ultrasound, and the maximum length and transverse diameter of the ovaries were measured at the same time, to calculate the average diameter of the ovaries, observe the morphology of endometrium, and measure the thickness of the endometrium. The implantation rate, clinical pregnancy rate, persistent pregnancy rate, and live birth rate were compared between the two groups. Results. There were no significant differences in serum E2, progesterone, endometrial thickness, recovered oocytes, mean number of transferred embryos, and mean score of leading embryo transfer between the DHEA group and the women who completed the first and second cycles ( P > 0.05 ). The AMH, antral follicle count, serum E2 on hCG day, the number of recovered oocytes, fertilized oocytes, and the fertilization rate in the DHEA group were higher than those in the control group ( P < 0.05 ). The doses of FSH on day 2, COH on day 3, and gonadotropin were lower than those in the control group ( P < 0.05 ). There was no significant difference in the total number of embryos, the number of high-quality embryos, and the number of transplanted embryos between the two groups ( P > 0.05 ). The implantation rate, clinical pregnancy rate, persistent pregnancy rate, and live birth rate in the DHEA group were higher than those in the control group ( P < 0.05 ). Conclusion. DHEA can significantly increase serum E2 level and improve IVF outcome by regulating the hormone synthesis process, thus improving oocyte and embryo quality.

scholarly journals ICSI Does Not Improve Live Birth Rates but Yields Higher Cancellation Rates Than Conventional IVF in Unexplained Infertility

2021 ◽  
Vol 7 ◽  
Author(s):  
Jianyuan Song ◽  
Tingting Liao ◽  
Kaiyou Fu ◽  
Jian Xu
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Unexplained Infertility ◽  
Clinical Pregnancy ◽  
University Hospital ◽  
Miscarriage Rate ◽  
Birth Rates ◽  
Live Birth Rates

Objectives: Unexplained infertility has been one of the indications for utilization of intracytoplasmic sperm injection (ICSI). However, whether ICSI should be preferred to IVF for patients with unexplained infertility remains an open question. This study aims to determine if ICSI improves the clinical outcomes over conventional in vitro fertilization (IVF) in couples with unexplained infertility.Methods: This was a retrospective cohort study of 549 IVF and 241 ICSI cycles for patients with unexplained infertility at a fertility center of a university hospital from January 2016 and December 2018. The live birth rate and clinical pregnancy rate were compared between the two groups. Other outcome measures included the implantation rate, miscarriage rate, and fertilization rate.Results: The live birth rate was 35.2% (172/488) in the IVF group and 33.3% (65/195) in ICSI group, P = 0.635. The two groups also had similar clinical pregnancy rates, implantation rates, and miscarriage rates. The fertilization rate of IVF group was significantly higher than that of ICSI group (53.8 vs. 45.7%, P = 0.000, respectively). Sixty-one and 46 patients did not transfer fresh embryos in IVF and ICSI cycles, respectively. Patients with IVF cycles had lower cancellation rates than those with ICSI (11.1 vs. 19.1%, P = 0.003, respectively).Conclusion: ICSI does not improve live birth rates but yields higher cancellation rates than conventional IVF in the treatment of unexplained infertility.

P–287 Uterine adenomyosis does not affect perinatal outcomes in ART treatments

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Trinchant ◽  
M Cruz ◽  
A Requena
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Ovum Donation ◽  
Uterine Adenomyosis

Abstract Study question Is adenomyosis associated with worse clinical and perinatal outcomes in ovum donation cycles? Summary answer Adenomyosis was associated with reduced live birth rate per embryo transfer but not with increased risk of miscarriage or worse perinatal outcomes than controls. What is known already The effect of adenomyosis on IVF/ICSI outcomes are controversial as studies addressing this issue are limited in number and heterogeneous. Conclusions withdrawn from previous works differ regarding the prospective or retrospective design of the study. Two different metanalysis conducted showed that adenomyosis reduced implantation and clinical pregnancy rate and increased miscarriage risk. However, current data regarding perinatal outcomes of assisted reproduction techniques cycles in patients diagnosed with uterine adenomyosis is scarce. Study design, size, duration A retrospective cohort study in which 3307 patients undergoing ovum donation cycles were included. Patients who underwent single embryo transfer (SET) between years 2018 and 2019 were included and divided into two groups: adenomyosis (n = 179) and controls (n = 3218). Participants/materials, setting, methods Inclusion criteria consisted of patients in an oocyte donation program who had fresh SET on day 5 blastocyst stage development. Patients diagnosed with miomas and/or severe endometriosis and those who had undergone previous uterine surgical interventions were excluded from the study. Cases consisted of patients with a history of either focal or diffuse adenomyosis diagnosed via transvaginal ultrasonography (TVUS). Main results and the role of chance Clinical pregnancy rate per embryo transfer was 82/179 (45.8%) in those women diagnosed with adenomyosis versus 1869/3218 (59.8%) in control group (OR = 0.57 95% CI. 0.41–0.78, p &lt; 0.001). Miscarriage rate was similar in the two study groups and differences found were not statistically significant, being 15/82 (18.3%) for adenomyosis and 309/1869 (16.5%) for control group. A lower live birth rate per embryo transfer was observed in women diagnosed with adenomyosis versus control, being 68/179 (38%) and 1560/3128 (49.9%) respectively (OR = 0.615 95% CI 0.44–0.85, p = 0.002). There were no statistically significant differences between childbirth delivery methods (vaginal versus caesarean section). Furthermore, means of gestational age at the time of delivery, newborn size and weight and incidences of low birth weight, preterm birth and admission in neonate intensive care unit (NICU) did not differ between the two groups. In addition, IVF and perinatal outcomes were similar in patients with diffuse adenomyosis compared to focal adenomyosis. Limitations, reasons for caution This is an observational study and thus possible confounders cannot be completely excluded. Diagnostic of adenomyosis is complex and, despite imaging via TVUS is both sensitive and specific, different criteria may be combined in order to fully assess the diagnostic. Wider implications of the findings: Published literature has described how adenomyosis negatively impacts clinical outcomes in ART cycles; however, data regarding perinatal results is scarce. This study is of interest as it provides a first insight for clinicians showing that adenomyosis affects clinical but not perinatal outcomes in ovum donation cycle. Trial registration number Not applicable

scholarly journals Laser-assisted Hatching Improves Live Birth Rate of Vitrified-warmed Blastocyst Transfer Cycles: a Case Control Study

2021 ◽  
Author(s):  
Shui-Ying Ma ◽  
Lian-Jie Li ◽  
Hui Zhao ◽  
Cheng Li ◽  
Haibin Zhao ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Monozygotic Twin ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Assisted Hatching ◽  
Vitro Fertilization ◽  
Biochemical Pregnancy

Abstract Background Assisted hatching is a widely accepted technique in assisted reproductive technology, however, it’s efficiency remains controversial and lack of data on safety. The aim of this study was to assess whether laser-assisted hatching improves clinical pregnancy results of vitrified-warmed blastocyst transfer cycles.Methods This was a retrospective cohort study of 4143 vitrified-warmed blastocyst transfer cycles from October 2014 to December 2015 at a single, university-based hospital. Cases involving blastocysts that survived after warming were divided into the assisted hatching (AH) group (n=1975) and non-AH group (n=2168). In the AH group, laser AH was performed for the warmed blastocysts before transfer. In the non-AH group, the warmed blastocysts were transferred without AH. The primary outcome was live birth rate after survived vitrified-warmed blastocyst transfers.Results No significant differences in age, endometrial preparation regimen, number of embryos transferred, or blastocyst developmental stage were found between the two groups (P>0.05). The biochemical pregnancy (67.0% vs. 63.6%; P=0.023; odds ratio [OR], 1.177; 95% confidence interval [CI], 1.032–1.344), clinical pregnancy (59.2% vs. 56.0%; P=0.041; OR, 1.163; 95% CI, 1.024–1.321), live birth (48.6% vs. 45.4%; P=0.041; OR, 1.160; 95% CI, 1.022–1.316), and implantation (52.1% vs. 49.3%; P=0.039) rates of the AH group were significantly higher than those of the non-AH group. The early miscarriage (17.1% vs. 17.8%; P=0.674), monozygotic twin (1.5% vs. 0.90%; P=0.214), and birth defect (3.1% vs. 3.6%; P=0.571) rates were similar in both groups. Conclusions In vitrified-warmed blastocyst transfer cycles, laser AH is associated with high clinical pregnancy and live birth rates. The benefits of AH outweigh its drawbacks, which include prolonged in vitro procedure, thermal damage, and higher workload in the in vitro fertilization laboratory.Trial registration: retrospectively registered

scholarly journals Effect of human chorionic gonadotropin injection before frozen embryo transfer on pregnancy outcomes in endometriosis infertility

2020 ◽  
Author(s):  
Yanbo Du ◽  
Lei Yan ◽  
Mei Sun ◽  
Yan Sheng ◽  
Xiufang Li ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Hormone Replacement ◽  
Live Birth Rate ◽  
Abortion Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Control Group

Abstract Purpose To investigate the effect of hCG in hormone replacement regime for frozen thawed embryo transfer in women with endometriosis. Methods We performed a retrospective, database-searched cohort study. The data of endometriosis patients who underwent frozen embryo transfer between 1/1/2009-31/8/2018 were collected. According to the protocols for frozen embryo transfer cycle, these patients were divided into two groups: Control group(n=305), and hCG group(n=362). And clinical pregnancy rate, live birth rate, early abortion rate, late abortion rate and ectopic pregnancy rate were compared between the two groups. Results There was a significant increase in clinical pregnancy rate in hCG group (56.6% vs. 48.2%, p=0.035) compared to the control group. And the live birth rate in hCG group (43.5% vs. 37.4%, p=0.113) also elevated, but the difference is statistically insignificant. Conclusion hCG administration in hormone replacement regime for FET increase the pregnancy rate in women with endometriosis.

scholarly journals Clinical Outcomes and Live Birth Rate (LBR) of Micro-TESE With ICSI-IVF in 968 Non-obstructive Azoospermia Patients From One Reproductive Medicine Center: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Yu Lan ◽  
Haiyan Zheng ◽  
Xin Fu ◽  
Tianwen Peng ◽  
Chen Liao ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Sperm Count ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Significant Difference ◽  
Intent To Treat

Abstract Background: Most of data available in the literature reported the sperm retrieval rate (SRR) and ICSI results of microdissection testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients with different etiologies. Unfortunately, there is currently a lack of comprehensive Intent-to-treat (ITT) data to guide clinicians in conducting comprehensive consultations with NOA patients. The aim of current study was to obtain more comprehensive evidence-based data and clinical outcomes for better consultation of NOA patients who opted to undergo micro-TESE combined with ICSI-IVF.Materials and methods: A retrospective study involved 968 NOA patients underwent micro-TESE during the period between January 2015 and December 2019. Those who had successful sperm retrieval and performed ICSI-IVF cycles were included in intent-to-treat (ITT) analysis. The primary outcome measure was the live birth rate (LBR). The cumulative pregnancy or live birth was defined as clinical pregnancy or at least one live-born baby resulting from an ICSI initiated cycle. Two kinds of stratification analyses were performed based on different etiologies of NOA and various amounts of sperm retrieved. The 'Student's t-test was used for comparison of continuous variables. One-way ANOVA was used to assess outcomes among more than two groups. Chi-squared (χ2) or Fisher's exact test was used for proportions.Results: The SRR of all 968 NOA patients undergoing micro-TESE was 44.6% (n=432). ITT analysis was performed in 424 patients, and ICSI-IVF was applied in 362 couples, leading to 171 clinical pregnancies (40.3%) and 161 live-birth deliveries (38.0%) in the first embryo transfer cycle. No significant difference was observed for per-protocol analysis between the groups of frozen sperm and fresh sperm in cumulative clinical pregnancy rate (CPR, 51.0% vs. 45.2%) and live-birth rate (LBR, 47.5% vs. 42.9%). NOA patients with Y chromosome azoospermia factor c (AZFc) microdeletions had the lowest rate of the high-score embryo on day 3 (4.4%, P<0.05) and the lowest cumulative CPR (22.2%, P<0.05). NOA patients with lower sperm count had significantly lower cumulative LBR than those with higher sperm count (25.0% vs. 49.2%, P<0.05).Conclusions: Micro-TESE is an effective sperm retrieval technique for NOA patients. Our data indicated no significant difference in the LBR between ICSI-IVF cycles using frozen or fresh testicular sperm.

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