{"id":48,"title":"Artificial intelligence-assisted microdissection testicular sperm extraction improves sperm retrieval efficiency and clinical outcomes in men with non-obstructive azoospermia: a retrospective cohort study","title_zh":"人工智能辅助显微取精术提高非梗阻性无精子症患者精子获取效率与临床结局：一项回顾性队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42989887","doi":"10.4103/aja202644","pmid":"42989887","journal":"Asian J Androl","kind":"paper","lang":"en","published_at":"2026-11-06T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Peng LF","Yu H"],"primary_topic":"male","topics":[{"slug":"male","score":13.0,"hits":["azoospermia","sertoli","sperm","testicular"]},{"slug":"art-clinical","score":6.0,"hits":["clinical pregnancy","icsi","intracytoplasmic sperm injection","live birth","live birth rate","ongoing pregnancy"]},{"slug":"ai-compute","score":4.0,"hits":["artificial intelligence"]},{"slug":"early-embryo","score":1.0,"hits":["blastocyst"]},{"slug":"contraception-health","score":1.0,"hits":["birth rate"]}],"topic_score":13.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":84.0,"final_score":89.0,"score_dims":{"novelty":80,"rigor":75,"impact":82,"relevance":95,"translation":88},"recommend_reason":"大样本（n=1286）双中心队列，直接展示AI辅助micro-TESE在取精率、围术期负担与ICSI/活产结局上的全面获益，并给出独立预测的校正结果，对男科手术与ART实验室流程改进有明确参考价值；唯回顾性设计、缺乏随机化与外部队列验证，需谨慎解读因果。","keywords":["非梗阻性无精子症","显微取精术","人工智能","ICSI结局","活产率","精子获取率"],"selected":1,"story_id":33,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究回顾性分析2020年1月至2024年12月四川两家生殖医学中心1286例连续非梗阻性无精子症（NOA）患者，其中542例接受AI辅助显微取精术（micro-TESE），744例接受常规手术，比较取精率（SRR）、围手术期指标、并发症及ICSI结局。结果显示，总体SRR为56.2%；AI组SRR显著更高（68.1% vs 47.6%，P<0.001），其中仅支持细胞综合征患者改善最明显（47.2% vs 22.7%）。AI组手术时间更短、出血更少、活检位点更少、住院更短、并发症更低，受精率、优质胚胎率、囊胚率、临床妊娠率、持续妊娠率及活产率均更优。多因素分析显示，AI辅助手术是SRR（OR=3.182）与活产（OR=1.876）的独立预测因素。作者认为，AI辅助micro-TESE可提升取精效率、降低围术期并发症并改善ICSI及活产结局，但仍需前瞻性多中心随机试验验证。","summary":"This study compared the efficacy, safety, and intracytoplasmic sperm injection (ICSI) outcomes of artificial intelligence (AI)-assisted versus conventional microdissection testicular sperm extraction (micro-TESE) in men with non-obstructive azoospermia (NOA). To this end, we retrospectively analyzed 1286 consecutive NOA patients undergoing micro-TESE at the two reproductive medicine center of Sichuan Provincial People's Hospital (Chengdu, China) and Sichuan Jinxin Xinan Women's and Children's Hospital (Chengdu, China) from January 2020 to December 2024, including 542 patients receiving AI-assisted procedures and 744 undergoing conventional surgery. The primary outcome was sperm retrieval rate (SRR), while secondary outcomes covered intraoperative parameters, postoperative complications, and ICSI outcomes, and univariable and multivariable logistic regression were performed to identify independent predictors of SRR and live birth. The results showed that the overall SRR reached 56.2% in the entire cohort, and the AI group had a significantly higher SRR (68.1% vs 47.6%, P < 0.001), with the most prominent improvement observed in patients with Sertoli cell-only syndrome (47.2% vs 22.7%, P < 0.001). The AI group also exhibited shorter operative time, less intraoperative blood loss, fewer biopsy sites, shorter postoperative hospital stay, and lower complication rates (all P < 0.001), as well as superior ICSI outcomes including higher fertilization, high-quality embryo, blastocyst, clinical pregnancy, ongoing pregnancy, and live birth rates (all P < 0.01). Further multivariable analysis confirmed that AI-assisted surgery serves as an independent predictor of both successful SRR (odds ratio [OR] = 3.182, 95% confidence interval [CI]: 2.374-4.265, P < 0.001) and live birth rate (OR = 1.876, 95% CI: 1.325-2.656, P < 0.001). Taken together, AI-assisted micro-TESE improves sperm retrieval efficiency, reduces perioperative morbidity, and enhances ICSI and live birth outcomes in NOA patients as an independent predictor for both SRR and live birth rate, and prospective multicenter randomized trials are warranted for further validation.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}