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