Authors
Ranjith Ramasamy, M.D., Campbell Bryson, B.A., Jennifer E. Reifsnyder, M.D., Queenie Neri, M.S., Gianpiero D. Palermo, M.D., Peter N. Schlegel, M.D.
Volume 99, Issue 2, Pages 372-376, February 2013
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 university hospital.
Patient(s):
Nine hundred and seventy patients with non-obstructive azoospermia.
Intervention(s):
Microdissection testicular sperm extraction (TESE), followed by intracytoplasmic sperm injection (ICSI).
Main outcome measure(s):
Sperm retrieval rate and clinical pregnancy rate.
Results:
Testicular sperm were successfully retrieved in 55% of men overall. Of those with sperm found, clinical pregnancy rate was 51% and live birth rate was 40%. Sperm retrieval rates were similar in men with Body Mass Index < 25, 25-30, and > 30 (59%, 57%, and 54% respectively). Mean BMI of men who contributed to pregnancy (27.3 + 4.9 kg/m2) was lower (p=0.04) than for men whose sperm did not contribute to a pregnancy (28.2 + 5.4 kg/m2). No man with BMI > 43 (n=11) contributed to a successful pregnancy, even though sperm were found in men with BMI upto 57 kg/m2. 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.
Conclusions:
Overweight men have lower clinical pregnancy rate after micro-TESE and ICSI compared to men with normal BMI. Men with BMI > 43 did not contribute to any pregnancies, despite successful sperm retrieval.
Read the full text at: http://www.fertstert.org/article/S0015-0282(12)02337-0/fulltext