Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients

Abstract This study aims to compare the sperm retrieval rate (SRR) achieved through microdissection testicular sperm extraction (micro-TESE) with the outcomes of intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia (NOA) who exhibit a partial deletion of the azoosperm...

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Main Authors: Yanqing Xia, Ke Feng, Xiaowei Qu, Feng Wan, Cuilian Zhang, Haibin Guo
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-03312-0
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author Yanqing Xia
Ke Feng
Xiaowei Qu
Feng Wan
Cuilian Zhang
Haibin Guo
author_facet Yanqing Xia
Ke Feng
Xiaowei Qu
Feng Wan
Cuilian Zhang
Haibin Guo
author_sort Yanqing Xia
collection DOAJ
description Abstract This study aims to compare the sperm retrieval rate (SRR) achieved through microdissection testicular sperm extraction (micro-TESE) with the outcomes of intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia (NOA) who exhibit a partial deletion of the azoospermia factor c(AZFc) region on the Y chromosome. From December 2016 to September 2023, the clinical data of patients with NOA who had AZFc deletions, which were identified through high-throughput sequencing, and who underwent micro-TESE were retrospectively analyzed. Based on the results of screening the AZFc region, the patients were categorized into three groups—the gr/gr deletion group (n = 17), the b2/b4 deletion group (n = 62), and the b2/b3 deletion group (n = 11). The SRR, embryo development, and embryo transfer outcomes were compared between the three groups. The SRR in the gr/gr deletion group was significantly lower than that in the b2/b4 deletion group (P = 0.010). Conversely, the SRR in the b2/b4 deletion group and b2/b3 deletion group were relatively high, at 64.5% (40/62) and 54.5(6/11),respectively; however, the number of micro-TESE procedures that extracted sperm with severe morphological abnormalities was 13, resulting in an available sperm rate of only 43.5% (27/62). No significant differences were observed across all groups regarding fertilized oocyte (2PN) rate, 2PN cleavage rate, D3 available embryo rate, high-quality embryo rate, blastocyst formation rate, number of transferred embryos, miscarriage rate, clinical pregnancy rate, or live birth delivery rate (P > 0.05). The micro-TESE outcomes in NOA patients with partial deletions in the AZFc region of the Y chromosome are most significantly negatively impacted by gr/gr deletion.Patients with b2/b4 deletion and b2/b3 deletion type should actively undergo surgical treatment to obtain biological descendants.
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spelling doaj-art-aeb9690eef824fd4ac458d71c8ecdf692025-08-20T03:38:15ZengNature PortfolioScientific Reports2045-23222025-07-011511610.1038/s41598-025-03312-0Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patientsYanqing Xia0Ke Feng1Xiaowei Qu2Feng Wan3Cuilian Zhang4Haibin Guo5The Center of Reproductive Medicine, Henan Provincial People’s HospitalThe Center of Reproductive Medicine, Henan Provincial People’s HospitalThe Center of Reproductive Medicine, Henan Provincial People’s HospitalThe Center of Reproductive Medicine, Henan Provincial People’s HospitalThe Center of Reproductive Medicine, Henan Provincial People’s HospitalThe Center of Reproductive Medicine, Henan Provincial People’s HospitalAbstract This study aims to compare the sperm retrieval rate (SRR) achieved through microdissection testicular sperm extraction (micro-TESE) with the outcomes of intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia (NOA) who exhibit a partial deletion of the azoospermia factor c(AZFc) region on the Y chromosome. From December 2016 to September 2023, the clinical data of patients with NOA who had AZFc deletions, which were identified through high-throughput sequencing, and who underwent micro-TESE were retrospectively analyzed. Based on the results of screening the AZFc region, the patients were categorized into three groups—the gr/gr deletion group (n = 17), the b2/b4 deletion group (n = 62), and the b2/b3 deletion group (n = 11). The SRR, embryo development, and embryo transfer outcomes were compared between the three groups. The SRR in the gr/gr deletion group was significantly lower than that in the b2/b4 deletion group (P = 0.010). Conversely, the SRR in the b2/b4 deletion group and b2/b3 deletion group were relatively high, at 64.5% (40/62) and 54.5(6/11),respectively; however, the number of micro-TESE procedures that extracted sperm with severe morphological abnormalities was 13, resulting in an available sperm rate of only 43.5% (27/62). No significant differences were observed across all groups regarding fertilized oocyte (2PN) rate, 2PN cleavage rate, D3 available embryo rate, high-quality embryo rate, blastocyst formation rate, number of transferred embryos, miscarriage rate, clinical pregnancy rate, or live birth delivery rate (P > 0.05). The micro-TESE outcomes in NOA patients with partial deletions in the AZFc region of the Y chromosome are most significantly negatively impacted by gr/gr deletion.Patients with b2/b4 deletion and b2/b3 deletion type should actively undergo surgical treatment to obtain biological descendants.https://doi.org/10.1038/s41598-025-03312-0Y chromosome microdeletionAzoospermia factor CNon-obstructive azoospermiamicro-TESE sperm retrieval rateIntracytoplasmic sperm injection
spellingShingle Yanqing Xia
Ke Feng
Xiaowei Qu
Feng Wan
Cuilian Zhang
Haibin Guo
Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients
Scientific Reports
Y chromosome microdeletion
Azoospermia factor C
Non-obstructive azoospermia
micro-TESE sperm retrieval rate
Intracytoplasmic sperm injection
title Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients
title_full Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients
title_fullStr Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients
title_full_unstemmed Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients
title_short Impact of AZFc deletion subtypes on sperm retrieval rates via micro-TESE and ICSI outcomes in non-obstructive azoospermia patients
title_sort impact of azfc deletion subtypes on sperm retrieval rates via micro tese and icsi outcomes in non obstructive azoospermia patients
topic Y chromosome microdeletion
Azoospermia factor C
Non-obstructive azoospermia
micro-TESE sperm retrieval rate
Intracytoplasmic sperm injection
url https://doi.org/10.1038/s41598-025-03312-0
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