Page 49 - Demo

CUAJ %u2022 APRIL 2025 %u2022 VOLUME 19, ISSUE 4 119Y chromosome microdeletion and reproductive outcomessperm was successfully retrieved in 10 cases (26.3%), while immature sperm (elongated or round spermatids) was found in 11 cases (29.0%). This difference in sperm retrieval outcomes was not statistically significant (p=0.663).For the purpose of analysis of ART outcomes using ejaculated or surgically retrieved mature sperm in both groups, we excluded 16 men (out of 19) from the YCM group due to use of sperm donor (n=1), no mature sperm found from mTESE (n=7), mTESE not done (n=6), or no associated IVF cycle information (n=2). Eighty-seven of 97 men from the control group were excluded from the ART outcomes analysis due to no sperm found after mTESE (n=28), no mTESE done (n=31), and no associated IVF cycle or unavailable information (n=28).Finally, three patients with a detected AZFc YCM and 10 patients without YCM, all of whom had successful sperm retrieval via mTESE or ejaculated sperm and had available ART cycle information, were included in the analysis of ICSI outcomes (Figure 1). Testicular (via mTESE) sperm was used in one out of three (the remaining two had ejaculated sperm) patients in the AZFc YCM group and in seven of 10 (the remaining three had ejaculated sperm) patients in the control group.The baseline characteristics of the 13 men with known ART outcomes (three AZFc YCM and 10 controls) were all similar in both groups (Table 2), while testosterone level differed and was higher in the YCM group (23.0%u00b113.1 vs. 9.4%u00b16.4 nmol/L, p=0.027). The general IVF-ICSI clinical outcomes of the YCM and control groups using either ejaculated or surgically retrieved mature sperm are shown in Table 3. The average number of oocytes retrieved, the oocyte maturation rate, and fertilization and cleavage rates were comparable between groups. The blastocyst formation did not significantly differ between the groups, although a trend towards poorer outcomes in the YCM group compared to the control group was noted (7.7% vs. 24.1%, p=0.078), similar to pregnancy rates and live births rates (20.0% vs. 72.7%, 0% vs. 40.0%, p=0.106 and 0.231, respectively). A total of five embryos were transferred in the YCM group (two blastocysts and three cleavage stage embryos at day 3), resulting in one pregnancy that ended in miscarriage. In contrast, 11 embryos were transferred in the control group and to date, four live births and one ongoing pregnancy have been recorded from female partners within the no YCM group.Table 2. Basic characteristics of patients with known In-vitro fertilization outcomes (n=13) with the use of mature (ejaculated or testicular) sperm for intracytoplasmic sperm injection Variable YCM group Control group pNumber of patients 3 10*Female age 29.0%u00b13.6 31.4%u00b14.0 0.386Male age 30.3%u00b11.5 33.7%u00b15.7 0.121Duration of infertility (years)FSH (mIU/ml) 10.7%u00b13.8 15.3%u00b17.9 0.359LH (mIU/ml) 6.0%u00b11.2 9.0%u00b14.3 0.265Testosterone (nmol/L) 23.0%u00b113.1 9.4%u00b16.4 0.027Use of testicular sperm for ICSI 1 3Use of ejaculated sperm for ICSI 2 7*Out of the 13 non-YCM men with ejaculated (n=3) and surgically retrieved testicular (n=10) sperm, 3/10 men from the testicular sperm group were lost to followup. Continuous data are expressed as mean %u00b1 SD and compared between two groups by Student%u2019s t-test. Categorical data are expressed as n/N (%) and compared between two groups by Chi-squared test or Fisher%u2019s exact test. FSH: follicle-stimulating hormone; ICSI: intracytoplasmic sperm injection; LH: luteinizing hormone; MT: Micro-TESE; YCM: Y chromosome microdeletion.Table 3. In vitro fertilization outcomes (n=13) with the use of mature (ejaculated or testicular) sperm for intracytoplasmic sperm injectionVariable YCM group Control group pNumber of patients 3 10*Number of oocytes retrieved 13.3%u00b12.1 19.4%u00b18.8 0.274Number of mature oocytes 8.7%u00b12.5 14.5%u00b16.1 0.142Overall number of mature oocytes 26 145Fertilization rate (%) 11/26 (42.3%) 72/145 (49.7%) 0.491Cleavage stage rates (%) 11/26 (42.3%) 57/145 (39.3%) 0.774Blastocyst rates (%) 2/26 (7.7%) 35/145 (24.1%) 0.078Embryos transferred (n) 5** 11Pregnancy rates (%) 1/5 (20.0%) 8/11 (72.7%) 0.106Live birth rates (%) 0/5 4/10 (40.0%)*** 0.231*Out of the 13 non-YCM men with ejaculated (n=3) and surgically retrieved testicular (n=10) sperm, 3/10 men from the testicular sperm group were lost to followup. **Two blastocysts and three cleavage stage day 3 embryos were transferred. ***One pregnancy was reported as ongoing. Continuous data are expressed as mean %u00b1 SD and compared between two groups by Student%u2019s t-test. Categorical data are expressed as n/N (%) and compared between two groups by Chisquared test or Fisher%u2019s exact test. YCM: Y chromosome microdeletion.