Congenital domestic absence of vas deferens (CBAVD) is a common factor in male infertility, and percutaneous epididymal sperm aspiration (PESA) combined with intracytoplasmic sperm injection (ICSI) is a primary clinical treatment, but the effect of the sperm obtained on pregnancy outcome remains to be explored. This study aimed to investigate the relationship between sperm motility with clinical outcome of PESA–ICSI in infertile males with CBAVD. A cohort of 110 couples was enrolled. In total, 76 infertile males were included in the high motility group, while the remaining 34 males were placed in the low motility group. Clinical pregnancy, embryo implantation rate and live birth rate were included as the primary outcome. After all follow-ups, we found that the high motility group achieved higher normal fertilization rates, cleavage rates, transplantable embryo rates and high-quality embryo rates than those in low motility group (normal fertilization rate, 78.2 ± 11.7% vs. 70.5 ± 10.2%, P = 0.003; cleavage rate, 97.1 ± 2.9% vs. 92.3 ± 3.0%, P = 0.000; transplantable embryo rate, 66.8 ± 14.9% vs. 58.6 ± 12.6%, P = 0.009 and high-quality embryo rate, 49.9 ± 10.5% vs. 40.5 ± 11.2%, P = 0.000). Additionally, compared with the low motility group, the clinical pregnancy rates, embryo implantation rates, and live birth rates in the high motility group were significantly increased (pregnancy rate, 61.8% vs. 26.5%, P = 0.009; embryo implantation rate, 36.5% vs. 18.0%, P = 0.044; live birth rate, 55.3% vs. 17.6%, P = 0.000). We concluded that the motility of sperm obtained by PESA affected the clinical outcome of ICSI in infertile males with CBAVD.

国内先天性输精管缺如（CBAVD）是男性不育的常见因素，经皮附睾精子抽吸术（PESA）联合胞浆内精子注射（ICSI）是临床主要治疗方法，但获得的精子对妊娠结局的影响仍然存在待探索。本研究旨在探讨精子活力与 CBAVD 不育男性 PESA-ICSI 临床结果之间的关系。纳入了 110 对夫妇的队列。共有 76 名不育男性被纳入高动力组，其余 34 名男性被置于低动力组。临床妊娠率、胚胎着床率和活产率作为主要结局指标。经过所有的随访，我们发现高能动组达到了更高的正常受精率、卵裂率、P = 0.003；裂解率，97.1 ± 2.9% vs. 92.3 ± 3.0%，P = 0.000；可移植胚胎率，66.8 ± 14.9% vs. 58.6 ± 12.6%，P = 0.009 和优质胚胎率，49.9 ± 10.5% vs. 40.5 ± 11.2%，P = 0.000）。此外，与低动力组相比，高动力组的临床妊娠率、胚胎着床率和活产率显着增加（妊娠率，61.8% vs. 26.5%，P = 0.009；胚胎着床率，36.5 % 对 18.0%，P = 0.044；活产率，55.3% 对 17.6%，P = 0.000）。我们得出结论，PESA 获得的精子活力会影响 CBAVD 不育男性 ICSI 的临床结果。