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Fertil Steril. 2013 Feb;99(2):372-6. doi: 10.1016/j.fertnstert.2012.10.025. Epub 2012 Oct 31.

Overweight men with nonobstructive azoospermia have worse pregnancy outcomes after microdissection testicular sperm extraction.

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1
Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York, USA.

Abstract

OBJECTIVE:

To evaluate the effect of obesity on the outcome of testicular sperm extraction (TESE) and assisted reproductive technology.

DESIGN:

Clinical retrospective study.

SETTING:

Center for reproductive medicine at a tertiary-care university hospital.

PATIENT(S):

Nine hundred seventy patients with nonobstructive azoospermia.

INTERVENTION(S):

Microdissection TESE followed by intracytoplasmic sperm injection (ICSI).

MAIN OUTCOME MEASURE(S):

Sperm retrieval rate and clinical pregnancy rate.

RESULT(S):

Testicular sperm were successfully retrieved in 55% of men overall. Of those with sperm found, clinical pregnancy rate was 51% and live birth rate 40%. Sperm retrieval rates were similar in men with body mass index (BMI) <25 kg/m(2), 25-30 kg/m(2), and >30 kg/m(2) (59%, 57%, and 54%, respectively). Mean BMI of men who contributed to pregnancy (27.3 ± 4.9 kg/m(2)) was lower than for men whose sperm did not contribute to a pregnancy (28.2 ± 5.4 kg/m(2)). No man with BMI >43 kg/m(2) (n = 11) contributed to a successful pregnancy, even though sperm were found in men with BMI up to 57 kg/m(2). On multivariable logistic regression analysis, male BMI was the only predictor of successful pregnancy among the variables analyzed, including male age, female age, and female BMI.

CONCLUSION(S):

Overweight men have lower clinical pregnancy rate after microdissection TESE and ICSI compared with men with normal BMI. Men with BMI >43 kg/m(2) did not contribute to any pregnancies, despite successful sperm retrieval.

[Indexed for MEDLINE]

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