ICSI outcome in surgically retrieved sperm compared with ejaculated sperm control

Authors

  • Pallavi S. Vishwekar Department of Obstetrics and Gynecology, DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India
  • Nikita Lad Department of IVF, DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India
  • Mamta Shivtare Department of IVF, DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India
  • Pradnya Shetty Department of IVF, DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20190847

Keywords:

Azoospermia, Ejaculated sperm, ICSI, Infertility, Surgically retrieved sperm

Abstract

Background: Globally, the prevalence of infertility is around 10% of the total population. 30% of these have male factor infertility. Azoospermia is found in 1% of men, in 20% of which, the etiology is a bilateral obstruction of the male genital tract while others have non obstructive azoospermia. In azoospermic men sperms are microsurgically retrieved from epididymis and testes by TESA and PESA respectively. The aim of this study was to evaluate the outcomes of intracytoplasmic sperm injection ICSI using surgically retrieved sperm of azoospermic men either obstructive or nonobstructive and to compare it with ejaculated sperms in men having severe oligospermia.

Methods: This was retrospective cohort study conducted based on the data collected from our reproductive endocrinology and infertility unit, 126 ICSI cycles performed during the period of 5 years were taken and divided into two groups, one with patients having ejaculated sperms with oligospermia and other group with patients who had surgically retrieved normal sperms due to azoospermia. Outcome of these ICSI cycles included fertilization, cleavage, biochemical and clinical pregnancy was assessed.

Results: In present study it was found that ICSI outcome was comparable in both the groups with ejaculated sperm and surgically retrieved sperm as fertilization rate (72% vs 65%), Implantation Rate (58 vs 51%), clinical pregnancy rate (CPR) (51% vs 44.82%) observed with ejaculated or retrieved sperm group respectively showed no statistical difference.

Conclusions: Present study shows that minimally invasive techniques of PESA and TESA can be successfully performed to retrieve sperm for ICSI in the treatment of azoospermic men which gives them the chance to father their biological child. The result of this study indicates that treatment outcomes of PESA/TESA-ICSI cycles compare favourably with that of ICSI using ejaculated sperm.

References

Edmund Sabanegh Jr, Ashok Agarwal, Marc Goldstein Male Infertility, Alan J. Wein, Campbell-walsh urology. 10th ed. Saunders Elsevier: Philadelphia, USA; 2012:616-648.

Hull MG, Glazener CM, Kelly NJ, Conway DI, Foster PA, Hinton RA, et al. Population study of causes, treatment, and outcome of infertility. Br Med J (Clin Res Ed). 1985;291(6510):1693-7.

NICE: National institute for health and clinical excellence. Fertility assessment and treatment for people with fertility problems. NICE clinical guidelines2013;156. Available at: www.nice.org.UK/guidance/c9156.

Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet. 1978;312(8085):366.

Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic sperm injection of single spermatozoon into an oocyte. Lancet. 1992;340:17-8.

Dohle GR, Ramos L, Pieters MH, Braat DD, Weber RF. Surgical sperm retrieval and intracytoplasmic sperm injection as treatment of obstructive azoospermia. Hum Reprod (Oxford, England). 1998;13(3):620-3.

Nicopoullos JD, Gilling-Smith C, Almeida PA, Norman-Taylor J, Grace I, Ramsay JW. Use of surgical sperm retrieval in azoospermic men: a meta-analysis. Fertil Steril. 2004;82(3):691-701.

Friedler S, Raziel A, Schachter M, Strassburger D, Bern O, Ron-El R. Outcome of first and repeated testicular sperm extraction and ICSI in patients with non-obstructive azoospermia. Hum Reprod. 2002;17(9):2356-61.

Friedler S, Raziel A, Strassburger D, Schachter M, Soffer Y, Ron-El R. Factors influencing the outcome of ICSI in patients with obstructive and non-obstructive azoospermia: a comparative study. Hum Reprod. 2002;17(12):3114-21.

Verheyen G, Vernaeve V, Van Landuyt L, Tournaye H, Devroey P, Van Steirteghem A. Should diagnostic testicular sperm retrieval followed by cryopreservation for later ICSI be the procedure of choice for all patients with non-obstructive azoospermia?. Hum Reprod. 2004;19(12):2822-30.

Palermo GD, Cohen J, Alikani M, Adler A, Rosenwaks Z. Intracytoplasmic sperm injection: a novel treatment for all forms of male factor infertility. Fertil Steril. 1995;63:1231-40.

Meniru GI, Gorgy A, Batha S, Clarke RJ, Podsiadly BT, Craft IL. Studies of percutaneous epididymal sperm aspiration (PESA) and intracytoplasmic sperm injection. Hum Reprod Update. 1998;4:57-71.

Aboulghar MA, Mansour RT, Serour GI, Fahmy I, Kamal A, Tawab NA, et al. Fertilization and pregnancy rates after intracytoplasmic sperm injection using ejaculate semen and surgically retrieved sperm. Fertil Steril. 1997;68:108-11.

Nicopoullos JD, Gilling-Smith C, Almeida PA, Norman-Taylor J, Grace I, Ramsay JW. Use of surgical sperm retrieval in azoospermic men: a meta-analysis. Fertil Steril. 2004;82:691-701.

Mansour RT, Aboulghar MA, Serour GI, Amin Y, Ramzi AM. The effect of sperm parameters on the outcome of intracy-toplasmic sperm injection. Fertil Steril. 1995;64:982-6.

Oates RD, Lobel SM, Harris DH, Pang S, Burgess CM, Carson RS. Efficacy of intracytoplasmic sperm injection using intentionally cryopreserved epididymal spermatozoa. Hum Reprod. 1996;11(1):133-8.

Nudell DM, Conaghan J, Pedersen RA, Givens CR, Schriock ED, Turek PJ. The mini-micro-epididymal sperm aspiration for sperm retrieval: a study of urological outcomes. Hum Reprod (Oxford, England). 1998;13(5):1260-5.

Janzen N, Goldstein M, Schlegel PN, Palermo GD, Rosenwaks Z. Use of electively cryopreserved microsurgically aspirated epididymal sperm with IVF and intracytoplasmic sperm injection for obstructive azoospermia. Fertil Steril. 2000;74(4):696-701.

Koscinski I, Viville S, Lefebvre-Kahlil V, Defossez A, Rigot JM. Pregnancies in cryptozoospermia with sperm ejaculated one day before ICSI: four case reports. J Androl. 2007;28(1):15-20.

Bendikson KA, Neri QV, Takeuchi T, Toschi M, Schlegel PN, Rosenwaks Z, et al. The outcome of intracytoplasmic sperm injection using occasional spermatozoa in the ejaculate of men with spermatogenic failure. J Urol. 2008;180(3):1060–4.

Nagy Z, Liu J, Cecile J, Silber S, Devroey P, Van Steirteghem A. Using ejaculated, fresh, and frozen-thawed epididymal and testicular spermatozoa gives rise to comparable results after intracytoplasmic sperm injection. Fertil Steril. 1995;63(4):808-15.

Abhyankar N, Kathrins M, Niederberger C. Use of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with cryptozoospermia: a meta-analysis. Fertil Steril. 2016;105(6):1469-75.

Ubaldi F, Nagy ZP, Rienzi L, Tesarik J, Anniballo R, Franco G, et al. Reproductive capacity of spermatozoa from men with testicular failure. Hum Reprod. 1999;14(11):2796-800.

Khalili MA, Manouchehri MA, Dehghani V. Treatment outcome following intracytoplasmic injection of sperm retrieved from ejaculate, epididymis, or testis of infertile men. Arch Iranian Med. 2004;7(3):232-6.

Naru T, Sulaiman MN, Kidwai A, Ather MH, Waqar S, Virk S, et al. Intracytoplasmic sperm injection outcome using ejaculated sperm and retrieved sperm in azoospermic men. Urol J. 2008;5(2):106-10.

Amirjannati N, Heidari-Vala H, Akhondi MA, Hosseini Jadda SH, Kamali K, Sadeghi MR. Comparison of intracytoplasmic sperm injection outcomes between n spermatozoa retrieved from testicular biopsy and from ejaculation in cryptozoospermic men. Androl. 2012;44 Suppl 1:704-9.

Jamal W, Vélez MP, Zini A, Phillips S, Hemmings R, Kadoch IJ. Surgically retrieved spermatozoa versus ejaculated spermatozoa in modified natural IVF- ICSI cycles. Reprod Biomed Online. 2012;25(3):242-7.

Göker EN, Sendag F, Levi R, Sendag H, Tavmergen E. Comparison of the ICSI outcome of ejaculated sperm with normal, abnormal parameters and testicular sperm. Eur J Obstet Gynecol Reprod Biol. 2002;104(2):129-36.

Ben-Ami I, Raziel A, Strassburger D, Komarovsky D, Ron-El R, Friedler S. Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa cryptozoospermic men. Fertil Steril. 2013;99(7):1867-71.

Negri L, Patrizio P, Albani E, Morenghi E, Benaglia R, Desgro M, et al. ICSI outcome is significantly better with testicular spermatozoa in patients with necrozoospermia: a retrospective study. Gynecol Endocrinol. 2014;30(1):48-52.

Downloads

Published

2019-02-26

Issue

Section

Original Research Articles