title: Overweight men with nonobstructive azoospermia have worse pregnancy outcomes after microdissection testicular sperm extraction.
abstract: OBJECTIVE
  To evaluate the effect of obesity on the outcome of testicular sperm extraction (TESE) and assisted reproductive technology.
  
  
  METHODS
  Clinical retrospective study.
  
  
  METHODS
  Center for reproductive medicine at a tertiary-care university hospital.
  
  
  METHODS
  Nine hundred seventy patients with nonobstructive azoospermia.
  
  
  METHODS
  Microdissection TESE followed by intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Sperm retrieval rate and clinical pregnancy rate.
  
  
  RESULTS
  Testicular sperm were successfully retrieved in 55% of men overall. Of those with sperm found, clinical pregnancy rate was 51% and live birth rate 40%. Sperm retrieval rates were similar in men with body mass index (BMI) <25 kg/m(2), 25-30 kg/m(2), and >30 kg/m(2) (59%, 57%, and 54%, respectively). Mean BMI of men who contributed to pregnancy (27.3 ± 4.9 kg/m(2)) was lower than for men whose sperm did not contribute to a pregnancy (28.2 ± 5.4 kg/m(2)). No man with BMI >43 kg/m(2) (n = 11) contributed to a successful pregnancy, even though sperm were found in men with BMI up to 57 kg/m(2). On multivariable logistic regression analysis, male BMI was the only predictor of successful pregnancy among the variables analyzed, including male age, female age, and female BMI.
  
  
  CONCLUSIONS
  Overweight men have lower clinical pregnancy rate after microdissection TESE and ICSI compared with men with normal BMI. Men with BMI >43 kg/m(2) did not contribute to any pregnancies, despite successful sperm retrieval.
authors.affiliation: Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Ranjith
authors.initials: R
authors.lastname: Ramasamy
authors.forename: Campbell
authors.initials: C
authors.lastname: Bryson
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Reifsnyder
authors.forename: Queenie
authors.initials: Q
authors.lastname: Neri
authors.forename: Gianpiero D
authors.initials: GD
authors.lastname: Palermo
authors.forename: Peter N
authors.initials: PN
authors.lastname: Schlegel
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000453:epidemiology* / Q000628:therapy*; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D042282:Microdissection / Q000706:statistics & numerical data; D009518:New York; D050177:Overweight / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018873:Pregnancy Rate; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D053625:Sperm Retrieval / Q000706:statistics & numerical data*