Testicular versus percutaneous epididymal sperm aspiration for patients with obstructive azoospermia: A systematic review and meta-analysis

Kuan Wei Shih, Ping You Shen, Chien Chih Wu, Yi No Kang

研究成果: 雜誌貢獻文章同行評審

15 引文 斯高帕斯(Scopus)

摘要

Background: Intracytoplasmic sperm injection (ICSI) is a popular treatment for male infertility due to obstructive azoospermia (OA). Testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA) are two common sperm retrieval approaches for ICSI among men with OA. However, the comparative efficacies of TESA and PESA have been debated for more than a decade and there has been no synthesis of the available evidence. This meta-analysis compared fertility outcomes between TESA and PESA among men with OA undergoing ICSI. Methods: We searched Embase, PubMed, ScienceDirect, and Web of Science to identify studies comparing the effectiveness of TESA and PESA for ICSI. Study quality was assessed using the Newcastle-Ottawa scale. Data were pooled using a random-effects model. Outcomes were fertilization rate, implantation rate, pregnancy rate, and miscarriage rate. Results are expressed as odds ratio (OR) with 95% confidence intervals (CIs). Study heterogeneity was evaluated by the I-square (I2) statistic. Results: Of 2,965 references retrieved, eight studies met eligibility criteria. These studies included 2,020 men receiving 2,060 ICSI cycles. The pooled results showed no significant differences in pregnancy and miscarriage rates between TESA and PESA groups, but TESA yielded a significantly higher implantation rate than PESA (OR =1.58, P=0.02, I2=24%). Conclusions: TESA and PESA yielded similar pregnancy and miscarriage rates for couples receiving ICSI because of OA, but each demonstrated unique advantages and disadvantages. Further studies are required to evaluate safety outcomes and efficacy for specific clinical groups.
原文英語
頁(從 - 到)631-640
頁數10
期刊Translational Andrology and Urology
8
發行號6
DOIs
出版狀態已發佈 - 1月 1 2019

ASJC Scopus subject areas

  • 生殖醫學
  • 泌尿科學

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