Testicular sperm extraction (tese) for intracytoplasmic sperm injection (icsi) in sub-saharan africa - a two - year multi-centre review in ghana

Several factors have been found to influence successful testicular sperm extraction treatment outcomes. This study evaluated treatment outcomes and assessed predictors of clinical pregnancy in obstructive azoospermia treated with testicular sperm extraction and intracytoplasmic sperm injection in Ghana. This study was a retrospective cohort study that reviewed archived data and evaluated treatment outcomes of cases of obstructive azoospermia at the Lister Hospital and and Ruma Hospital. The data were retrieved from the hospital records at the two study sites. A structured data collection form was used to collect and record essential data such on sociodemographic, treatment details and outcomes. Cases of obstructive azoospermia that met the inclusion criteria were included in the study.Descriptive data were expressed in the form of frequencies and percentages. Associations between the dependent and independent variables were analyzed using multiple logistic regression and reported as odds ratios (OR). The confidence interval (CI) was set at 95% and p-value <0.05 was considered significant. Sixty-seven men seeking treatment for obstructive azoospermia at the Lister Hospital & Fertility Centre as well as the Ruma Fertility and Specialist Hospital participated in the study. The mean age of the male participants was 42.43 years ± 9.11 standard deviation (SD) while the mean age of their partners was 32.89 years ± 5.73 SD. The average duration of infertility before intervention was 5.01 years ± 3.60 SD. Successful pregnancy was observed in 35 (52.2%) of the 67 participants. After adjusting for confounders, the odds of successful pregnancy is 0.07 times reduced for every additional year to the male’s age [AOR = 0.93 (95% CI = 0.87 – 0.99), p=0.02]. Overall pregnancy rate following TESE/ICSI from our study was 52.2%. A man’s age was a strong predictor of clinical pregnancy following TESE/ICSI for obstructive azoospermia in Ghana.