title: Relationship of paternal age with outcome of percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection, in cases of congenital bilateral absence of the vas deferens.
abstract: OBJECTIVE
  To assess the relationship between paternal age and the outcome of percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection (ICSI) in patients with congenital bilateral absence of the vas deferens (CBAVD).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  In vitro fertilization centers.
  
  
  METHODS
  Eighty-five (male) CBAVD patients who underwent percutaneous epididymal sperm aspiration with ICSI were divided into 3 age groups; <30 years (n = 27); aged 30-40 years (n = 32); and aged >40 years (n = 26).
  
  
  METHODS
  History taking, clinical examination, semen analysis, percutaneous epididymal sperm aspiration with subsequent ICSI.
  
  
  METHODS
  Sperm retrieval, clinical pregnancy, and "take-home baby."
  
  
  RESULTS
  The number of sperm retrieved by percutaneous epididymal sperm aspiration significantly decreased with advancing age in the studied groups (0.63, 0.31, and 0.18 million, respectively), concomitant with significant decreases in the outcomes of clinical pregnancy (55.5%, 43.7%, and 23.1%, respectively) and "take-home baby" (48.1%, 40.6%, and 11.5%, respectively). Male age was significantly negatively correlated with retrieved sperm count, sperm motility, sperm vitality, and normal sperm morphology. Multiple logistic regression, adjusted for confounding factors, with male age, and sperm count obtained using percutaneous epididymal sperm aspiration, was significant. The receiver operating characteristic curve showed that a sperm count of 0.55 million as a cutoff value could predict clinical pregnancy with an accuracy of 77.4%, with 82.9% sensitivity and 62% specificity, and "take-home baby" with an accuracy of 81.7%, with 93.1% sensitivity and 62.5% specificity.
  
  
  CONCLUSIONS
  In cases of CBAVD, male age has a negative effect on retrieved-sperm count, motility, vitality, and normal sperm morphology; number of retrieved sperm predicted both clinical pregnancy and "take-home baby" outcomes in subsequent ICSI.
authors.affiliation: Department of Andrology, Mansoura University, Mansoura, Egypt.
authors.forename: Samir
authors.initials: S
authors.lastname: Elhanbly
authors.affiliation: Department of Andrology, Mansoura University, Mansoura, Egypt.
authors.forename: Moustafa A
authors.initials: MA
authors.lastname: El-Saied
authors.affiliation: Department of Obstetrics & Gynecology, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fawzy
authors.affiliation: Department of Obstetrics & Gynecology, Mansoura University, Mansoura, Egypt.
authors.forename: Abdelaziz
authors.initials: A
authors.lastname: El-Refaeey
authors.affiliation: Department of Andrology & Sexology, Cairo University, Cairo, Egypt. Electronic address: taymour1155@link.net.
authors.forename: Taymour
authors.initials: T
authors.lastname: Mostafa
mesh_terms: D000328:Adult; D004534:Egypt; D005260:Female; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D008297:Male; D010331:Paternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012307:Risk Factors; D013076:Sperm Count; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval; D016896:Treatment Outcome; D014564:Urogenital Abnormalities / Q000150:complications*; D014649:Vas Deferens / Q000002:abnormalities*
keywords: CBAVD; ICSI; Male infertility; PESA; semen