J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://jcgo.elmerpub.com

Original Article

Volume 14, Number 4, December 2025, pages 176-183

Impact of Severe Male Factor Infertility on In Vitro Fertilization-Intracytoplasmic Sperm Injection Outcomes: A Retrospective Cohort Study

↓ Figure 1. Receiver operating characteristic (ROC) curve illustrating the predictive performance of severe male factor infertility status on pregnancy outcome in IVF-ICSI cycles. Area under curve (AUC) = 0.593. IVF-ICSI: in vitro fertilization-intracytoplasmic sperm injection.

↓ **Table 1.** Distribution of Male Factor, Female Factor, and Source of Sperm Between Two Study Groups
Male factor

Group 1 (n = 51)	Observed	34	17	0		< 0.001
	% within row	66.70%	33.30%	0.00%
Group 2 (n = 51)	Observed	0	3	48
	% within row	0.00%	5.90%	94.10%
Group 1 (n = 51)	Observed	11	0	0	40	< 0.001
	% within row	21.6%	0.00%	0.00%	78.4%
Group 2 (n = 51)	Observed	22	8	18	3
	% within row	43.10%	15.70%	35.30%	5.90%
P-values calculated using Chi-square test. Group 1: couples with severe male factor infertility undergoing IVF-ICSI with autologous sperm. Group 2: couples without male factor infertility (including those using donor sperm). OAT: oligoasthenoteratozoospermia; PCOS: polycystic ovary syndrome.
Group 1 (n = 51)	Observed	33	18	0		< 0.001
	% within row	64.70%	35.30%	0.00%
Group 2 (n = 51)	Observed	48	0	3
	% within row	94.10%	0.00%	5.90%

↓ Table 1. Distribution of Male Factor, Female Factor, and Source of Sperm Between Two Study Groups

Male factor

Study groups

Severe OAT

Azoospermia

Absent

P-value

Group 1 (n = 51)

Observed

< 0.001

% within row

66.70%

33.30%

0.00%

Group 2 (n = 51)

Observed

% within row

0.00%

5.90%

94.10%

Female factor

Study groups

PCOS

Tubal block

Unexplained infertility

Absent

P-value

Group 1 (n = 51)

Observed

< 0.001

% within row

21.6%

0.00%

78.4%

Group 2 (n = 51)

Observed

% within row

43.10%

15.70%

35.30%

5.90%

Sperm source

Study groups

Ejaculate

Surgically retrieved

Donor

P-value

P-values calculated using Chi-square test. Group 1: couples with severe male factor infertility undergoing IVF-ICSI with autologous sperm. Group 2: couples without male factor infertility (including those using donor sperm). OAT: oligoasthenoteratozoospermia; PCOS: polycystic ovary syndrome.

Group 1 (n = 51)

Observed

< 0.001

% within row

64.70%

35.30%

0.00%

Group 2 (n = 51)

Observed

% within row

94.10%

0.00%

5.90%

↓ **Table 2.** Distribution of Female Age, BMI, and Ovarian Reserve Markers Between Two Study Groups
Study groups	N	Missing	Mean	Median	SD	Shapiro-Wilk P	Independent samples t-test
AMH and AFC were non-normally distributed (Shapiro-Wilk test); thus, the Mann-Whitney U test was used. Baseline characteristics were similar between groups. AFC: antral follicle count; AMH: anti-Müllerian hormone; BMI: body mass index; SD: standard deviation.
Age (years)
Group 1	51	0	30	30	3.37	0.082	Student’s t-test	0.135
Group 2	51	0	30.94	31	2.91
BMI (kg/m²)
Group 1	51	0	23.29	24	2.63	0.272	Student’s t-test	0.076
Group 2	51	0	24.35	24	3.29
AMH (ng/mL)
Group 1	48	3	4.31	4.1	2.47	< 0.001	Mann-Whitney U test	0.994
Group 2	48	3	4.35	3.45	2.39
AFC
Group 1	48	3	21.1	18	11.65	< 0.001	Mann-Whitney U test	0.1
Group 2	48	3	23.9	21.5	10.49

↓ Table 2. Distribution of Female Age, BMI, and Ovarian Reserve Markers Between Two Study Groups

Study groups

Missing

Mean

Median

Shapiro-Wilk P

Independent samples t-test

Test used

P-value

AMH and AFC were non-normally distributed (Shapiro-Wilk test); thus, the Mann-Whitney U test was used. Baseline characteristics were similar between groups. AFC: antral follicle count; AMH: anti-Müllerian hormone; BMI: body mass index; SD: standard deviation.

Age (years)

Group 1

3.37

0.082

Student’s t-test

0.135

Group 2

30.94

2.91

BMI (kg/m²)

Group 1

23.29

2.63

0.272

Student’s t-test

0.076

Group 2

24.35

3.29

AMH (ng/mL)

Group 1

4.31

4.1

2.47

< 0.001

Mann-Whitney U test

0.994

Group 2

4.35

3.45

2.39

AFC

Group 1

21.1

11.65

< 0.001

Mann-Whitney U test

0.1

Group 2

23.9

21.5

10.49

↓ **Table 3.** Clinical Pregnancy Distribution Between Study Groups
Study groups	Pregnancy	P value
Group 1
Observed	35	16	0.107
% within row	68.60%	31.40%
Group 2
Observed	42	9
% within row	82.40%	17.60%
Sperm source
Ejaculate with male factor infertility (group 1)
Observed	24	9	0.365
% within row	72.70%	27.30%
Ejaculate without male factor Infertility (group 2)
Observed	39	9
% within row	81.30%	18.80%
Surgically retrieved sperms (group 1)
Observed	11	6	0.219
% within row	64.70%	35.30%
Donor sperms (group 2)
Observed	3	0
% within row	100.00%	0.00%

↓ Table 3. Clinical Pregnancy Distribution Between Study Groups

Study groups

Pregnancy

P value

Yes

Group 1

Observed

0.107

% within row

68.60%

31.40%

Group 2

Observed

% within row

82.40%

17.60%

Sperm source

Ejaculate with male factor infertility (group 1)

Observed

0.365

% within row

72.70%

27.30%

Ejaculate without male factor Infertility (group 2)

Observed

% within row

81.30%

18.80%

Surgically retrieved sperms (group 1)

Observed

0.219

% within row

64.70%

35.30%

Donor sperms (group 2)

Observed

% within row

100.00%

0.00%

↓ **Table 4.** Univariate Logistic Regression Model Assessing the Impact of Severe Male Factor Infertility (Group 1 vs. Group 2) on Clinical Pregnancy Outcomes Following IVF-ICSI
Estimates represent the log odds of “pregnancy = yes” vs. “pregnancy = no”. Group 1: couples with severe male factor infertility undergoing IVF-ICSI with autologous sperm. Group 2: couples without male factor infertility (including those using donor sperm).
Model fit measures
Model	Deviance	AIC	R²_McF
1	111	115	0.0231
Note: Models estimated using sample size of N = 102
Model coefficients - pregnancy
						95% Confidence interval
Predictor	Estimate	SE	Z	P	Odds ratio	Lower	Upper
Male factor
Group 1 - Group 2	-0.758	0.475	-1.59	0.111	0.469	0.185	1.19

↓ Table 4. Univariate Logistic Regression Model Assessing the Impact of Severe Male Factor Infertility (Group 1 vs. Group 2) on Clinical Pregnancy Outcomes Following IVF-ICSI

Estimates represent the log odds of “pregnancy = yes” vs. “pregnancy = no”. Group 1: couples with severe male factor infertility undergoing IVF-ICSI with autologous sperm. Group 2: couples without male factor infertility (including those using donor sperm).

Model fit measures

Model

Deviance

AIC

R²_McF

111

115

0.0231

Note: Models estimated using sample size of N = 102

Model coefficients - pregnancy

95% Confidence interval

Predictor

Estimate

Odds ratio

Lower

Upper

Male factor

Group 1 - Group 2

-0.758

0.475

-1.59

0.111

0.469

0.185

1.19

↓ **Table 5.** Multivariate Logistic Regression Model Evaluating the Association Between Severe Male Factor Infertility and Clinical Pregnancy Following IVF-ICSI, Adjusting for Female Partner Characteristics (Age, BMI, AMH, and AFC)
Estimates represent the log odds of “pregnancy = yes” vs. “pregnancy = no”. Group 1: couples with severe male factor infertility undergoing IVF-ICSI with autologous sperm. Group 2: couples without male factor infertility (including those using donor sperm). AFC: antral follicle count; AMH: anti-Müllerian hormone; BMI: body mass index; SD: standard deviation.
Model fit measures
Model	Deviance	AIC	R²_McF
1	101	113	0.0470
Note. Models estimated using sample size of N = 96
Model coefficients - pregnancy
						95% Confidence interval
Predictor	Estimate	SE	Z	P	Odds ratio	Lower	Upper
Male factor
Group 1 - Group 2	-0.82047	0.5199	-1.578	0.115	0.440	0.15891	1.22
AFC	0.00636	0.0339	0.187	0.851	1.006	0.94163	1.08
AMH	0.14562	0.1649	0.883	0.377	1.157	0.83731	1.60
BMI	-0.03696	0.0896	-0.413	0.680	0.964	0.80855	1.15
Age	0.05744	0.0847	0.678	0.497	1.059	0.89718	1.25

↓ Table 5. Multivariate Logistic Regression Model Evaluating the Association Between Severe Male Factor Infertility and Clinical Pregnancy Following IVF-ICSI, Adjusting for Female Partner Characteristics (Age, BMI, AMH, and AFC)

Model fit measures

Model

Deviance

AIC

R²_McF

101

113

0.0470

Note. Models estimated using sample size of N = 96

Model coefficients - pregnancy

95% Confidence interval

Predictor

Estimate

Odds ratio

Lower

Upper

Male factor

Group 1 - Group 2

-0.82047

0.5199

-1.578

0.115

0.440

0.15891

1.22

AFC

0.00636

0.0339

0.187

0.851

1.006

0.94163

1.08

AMH

0.14562

0.1649

0.883

0.377

1.157

0.83731

1.60

BMI

-0.03696

0.0896

-0.413

0.680

0.964

0.80855

1.15

Age

0.05744

0.0847

0.678

0.497

1.059

0.89718

1.25