Meta-analysis Of Testicular Sperm Aspiration Versus Percutaneous Epididymal Sperm Aspiration For Introcytoplasmic Sperm Injection

Objective: To compare the efficiency of testicular sperm aspiration and percutaneous epididymal sperm aspiration for patients receiving intracytoplasmic sperm injection(ICSI)assisted reproduction.Methods: We searched PubMed,EMBASE,Cochrane Library,CNKI,Wanfang database and VIP database,and all publications before October 2017 which related to comparing testicular sperm aspiration and percutaneous epididymal sperm aspiration for ICSI were browsed.According to the inclusion and exclusion criteria,the literature was screened and the data were extracted.The Newcastle-Ottawa Scale(NOS)was recommended for quality evaluation of non-randomized studies,and RevMan 5.3 was used for meta-analysis.Results: A total of 20 literatures were recruited,including 1464 cycles and 2526 cycles used sperm by testicular sperm aspiration andpercutaneous epididymal sperm aspiration for ICSI,respectively.The results based on meta-analysis showed that no significant differences could be observed between groups using testicular sperm aspiration and percutaneous epididymal sperm aspiration in rates of pregnancy(RR=1.06,95%CI=0.99?1.13,P= 0.110),abortion(RR=0.99,95% CI=0.76?1.30,P=0.970),live birth(RR= 0.99,95%CI =0.86?1.14,P=0.880),ectopic pregnancy(RR= 1.44,95%CI=0.70?2.95,P=0.320),deformity(RR=1.71,95%CI=0.50?5.80,P=0.390),singleton(RR=0.95,95%CI= 0.85?1.06,P=0.380),multiple pregnancy(RR=1.12,95%CI=0.90?1.39,P=0.320),respectively.In addition,no complications,such as postoperative infection,scrotal hematoma or sexual dysfunction,was reported between two groups.Conclusion: Testicular sperm aspiration and percutaneous epididymal sperm aspiration would be similarly safe and efficient for patients receiving ICSI assisted reproduction.