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Review
. 2024 Aug 21;13(16):4939.
doi: 10.3390/jcm13164939.

Non-Obstructive Azoospermia and Intracytoplasmic Sperm Injection: Unveiling the Chances of Success and Possible Consequences for Offspring

Ahmad Majzoub  1   2 , Marina C Viana  3 , Arnold P P Achermann  3 , Isadora T Ferreira  4 , Rita J Laursen  5 , Peter Humaidan  5   6 , Sandro C Esteves  3   6   7
Affiliations
Review

Non-Obstructive Azoospermia and Intracytoplasmic Sperm Injection: Unveiling the Chances of Success and Possible Consequences for Offspring

Ahmad Majzoub et al. J Clin Med. .

Abstract

Non-obstructive azoospermia (NOA) is found in up to 15% of infertile men. While several causes for NOA have been identified, the exact etiology remains unknown in many patients. Advances in assisted reproductive technology, including intracytoplasmic sperm injection (ICSI) and testicular sperm retrieval, have provided hope for these patients. This review summarizes the chances of success with ICSI for NOA patients and examines preoperative factors and laboratory techniques associated with positive outcomes. Furthermore, we reviewed possible consequences for offspring by the use of ICSI with testicular sperm retrieved from NOA patients and the interventions that could potentially mitigate risks. Testicular sperm retrieved from NOA patients may exhibit increased chromosomal abnormalities, and although lower fertilization and pregnancy rates are reported in NOA patients compared to other forms of infertility, the available evidence does not suggest a significant increase in miscarriage rate, congenital malformation, or developmental delay in their offspring compared to the offspring of patients with less severe forms of infertility or the offspring of fertile men. However, due to limited data, NOA patients should receive specialized reproductive care and personalized management. Counseling of NOA patients is essential before initiating any fertility enhancement treatment not only to mitigate health risks associated with NOA but also to enhance the chances of successful outcomes and minimize possible risks to the offspring.

Keywords: assisted reproductive technology; intracytoplasmic sperm injection; male infertility; non-obstructive azoospermia; offspring health; pregnancy; review; sperm retrieval; spermatogenic failure; testis.

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Conflict of interest statement

Ahmad Majzoub is an employee of Hamad Medical Corporation. Marina C Viana, Arnold P.P. Achermann, and Sandro C. Esteves are employees of ANDROFERT. Rita J. Laursen and Peter Humaidan are employees of Skive Fertility Clinic. These companies did not play any role in the collection or analysis of data presented in this paper. Isadora Ferreira has nothing to disclose.

Figures

Figure 1
Figure 1
Etiology of non-obstructive azoospermia.
Figure 2
Figure 2
(A) Intracytoplasmic sperm injection; (B) trophectoderm biopsy for preimplantation genetic testing.
Figure 3
Figure 3
Testicular sperm retrieval techniques.
Figure 4
Figure 4
Outcomes of intracytoplasmic sperm injection on the health of offspring from patients with non-obstructive azoospermia.
See this image and copyright information in PMC

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