Relationship of paternal age with outcome of percutaneous epididymal sperm aspiration intracytoplasmic sperm injection in cases of congenital bilateral absence of the vas deferens

Capsule:
In cases of congenital bilateral absence of the vas deferens, advanced paternal age has a negative effect on retrieved-sperm parameters.

Authors:
Samir Elhanbly, M.D., Moustafa A. El-Saied, M.D., Mohamed Fawzy, M.D., Abdelaziz El-Refaeey, M.D., Taymour Mostafa, M.D.

Volume 104, Issue 3, Pages 602-606

Abstract:

Objective:
To assess the relationship between paternal age and the outcome of percutaneous epididymal sperm aspiration–intracytoplasmic sperm injection (ICSI) in patients with congenital bilateral absence of the vas deferens (CBAVD).

Design:
Prospective cohort study.

Setting:
In vitro fertilization centers.

Patient(s):
Eighty-five (male) CBAVD patients who underwent percutaneous epididymal sperm aspiration with ICSI were divided into 3 age groups; <30 years (n = 27); aged 30–40 years (n = 32); and aged >40 years (n = 26).

Intervention(s):
History taking, clinical examination, semen analysis, percutaneous epididymal sperm aspiration with subsequent ICSI.

Main Outcome Measure(s):
Sperm retrieval, clinical pregnancy, and “take-home baby.”

Result(s):
The number of sperm retrieved by percutaneous epididymal sperm aspiration significantly decreased with advancing age in the studied groups (0.63, 0.31, and 0.18 million, respectively), concomitant with significant decreases in the outcomes of clinical pregnancy (55.5%, 43.7%, and 23.1%, respectively) and “take-home baby” (48.1%, 40.6%, and 11.5%, respectively). Male age was significantly negatively correlated with retrieved sperm count, sperm motility, sperm vitality, and normal sperm morphology. Multiple logistic regression, adjusted for confounding factors, with male age, and sperm count obtained using percutaneous epididymal sperm aspiration, was significant. The receiver operating characteristic curve showed that a sperm count of 0.55 million as a cutoff value could predict clinical pregnancy with an accuracy of 77.4%, with 82.9% sensitivity and 62% specificity, and “take-home baby” with an accuracy of 81.7%, with 93.1% sensitivity and 62.5% specificity.

Conclusion(s):
In cases of CBAVD, male age has a negative effect on retrieved-sperm count, motility, vitality, and normal sperm morphology; number of retrieved sperm predicted both clinical pregnancy and “take-home baby” outcomes in subsequent ICSI.

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