RESUMO
BACKGROUND: Microdissection testicular sperm extraction (mTESE) is the gold standard approach in sperm retrieval in men with non-obstructive azoospermia (NOA). The purpose of the study was to assess the outcomes for Irish men who have undergone mTESE with a single surgeon. METHODS: This is a retrospective, single cohort study. Thirty-four patients underwent mTESE between September 2015 and June 2019. A p<0.05 was considered statistically significant. RESULTS: In this study, sperm retrieval rate (SRR) was 47.06%. (16/34). The mean age in those who had retrieved sperm at mTESE was 37.9±2.6 years. Johnson Score (JS) and FSH were statistically different between successful and unsuccessful mTESE groups (p=0.017*10-5 and p=0.004, respectively). Optimal cutoff values for FSH, T and JS were 15 IU/L, 13 nmol/L and 5, respectively. The pregnancy rate was 63.64% (7/11) among men who went on to use mTESE sperm in an ICSI cycle. CONCLUSION: The combination of mTESE/Intracytoplasmic sperm injection (ICSI) is the best option available for men with NOA who prefer to achieve paternity using their own DNA. Given the overall SRRs in mTESE, it is imperative to continue research for a predictive model to better counsel azoospermic men regarding the use of mTESE. For this purpose, large, multicenter, randomized controlled trials are needed.
RESUMO
OBJECTIVES: This paper reports the findings of two studies that examined factors predicting infertility distress in male partners within couples with an infertility diagnosis and where the couple was receiving fertility treatment. DESIGN: A cross-sectional design was implemented using a questionnaire battery (The questionnaire battery comprised an inventory of four different standardised questionnaires compiled together into one booklet) compiled from earlier theory-building qualitative research conducted by the authors. METHODS: Infertility related distress was examined in relation to a number of psychosocial variables including relationship dynamics, self-esteem, current mental health and attitudes towards idealised masculinity. The questionnaire battery was completed by 167 men undergoing or consulting for fertility treatment. Participants were recruited through Irish fertility clinics (Study 1, n = 111) and through an online survey (Study 2, n = 55). RESULTS: Regression analyses identified four variables that predicted variance in infertility distress in both studies: 'Attitude towards idealised masculinity', 'Mental health', 'Relationship satisfaction' and 'Self-esteem'. This finding was found to be robust having controlled for age, time since diagnosis, number of attempts at treatment and diagnostic category (male factor, female factor or mixed factor infertility). ConclusiON: Recommendations for fertility clinics and mental health professionals should be made in relation to managing infertility distress and supporting couples during fertility treatment.
