Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in  Management of Obstructive Azoospermia: A Two-Year Multicenter Review in Ghana

Promise  E. Sefogah; Alim  Swarray-Deen; Edem  K. Hiadzi; Rudolph  K. Adageba; Nana  Essuman Oduro; Hanson  G. Nuamah; Mercy  A. Nuamah

doi:10.18502/jri.v23i4.10811

Promise E. Sefogah Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ghana Medical School, Accra, Ghana
Alim Swarray-Deen Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ghana Medical School, Accra, Ghana
Edem K. Hiadzi Department of Obstetrics and Gynaecology, Lister Hospital and Fertility Centre, Accra, Ghana
Rudolph K. Adageba Department of Obstetrics and Gynaecology, Ruma Fertility and Specialist Hospital, Kumasi, Ghana
Nana Essuman Oduro Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
Hanson G. Nuamah Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
Mercy A. Nuamah Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ghana Medical School, Accra, Ghana

DOI: https://doi.org/10.18502/jri.v23i4.10811

Keywords: Azoospermia, Intracytoplasmic sperm injection, Male infertility, Testicular sperm retrieval.

Abstract

Background: The objective of this study was to evaluate treatment outcomes and assess predictors of clinical pregnancy in obstructive azoospermia cases treated with testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) in Ghana.

Methods: This study was a retrospective study conducted on 67 men seeking treatment for obstructive azoospermia at two study sites in Ghana from January 2018 to December 2019. First, archived data were reviewed and treatment outcomes of cases of obstructive azoospermia from the hospital records were evaluated. Infertile men who met the inclusion criteria were recruited. Descriptive data were expressed in the form of frequencies and percentages. The dependent and independent variables were analyzed using multiple logistic regression and reported as odds ratios (ORs). The confidence interval (CI) was set at 95% and a p-value <0.05 was considered significant.

Results: The mean age of male participants was 42.43±9.11 years (mean±SD) while the mean age of their partners was 32.89±5.73 years (mean±SD). The average duration of infertility before intervention was 5.01±3.60 years (mean±SD). Successful pregnancy was observed in 52.2% (35/67) of the participants. After adjusting for confounders, the rate of a successful clinical pregnancy was 0.07 lower for every additional year increase in the male’s age [AOR=0.93 (95%CI=0.87 - 0.99), p=0.02].

Conclusion: Overall the rate of clinical pregnancy following TESE/ICSI from our study was 52.2%. A man’s age was a strong predictor of successful clinical pregnancy among couples treated with TESE-ICSI for obstructive azoospermia in Ghana.