Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men

Testicular sperm extraction is justified in patients with cryptozoospermia who fail to conceive by ICSI using ejaculated spermatozoa, as it offers a higher pregnancy rate.

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Authors

Ido Ben-Ami, M.D., Ph.D., Arieh Raziel, M.D., Deborah Strassburger, Ph.D., Daphna Komarovsky, B.Sc., Raphael Ron-El, M.D., Shevach Friedler, M.D.

Volume 99, Issue 7, Pages 1867-1871, June 2013

Abstract

Objective:

To compare intracytoplasmic sperm injection (ICSI) outcome of patients with cryptozoospermia after use of ejaculated versus testicular sperm in different cycles of the same patients.

Design:

Retrospective cohort study.

Setting:

University-affiliated infertility center.

Patient(s):

A total of 17 patients with cryptozoospermia who underwent a total of 116 ICSI cycles.

Intervention(s):

The patients initially underwent several ICSI cycles using ejaculated sperm (n = 68, 58.6%) that were followed by ICSI cycles using testicular sperm (n = 48, 41.4%).

Main Outcome Measure(s):

Fertilization rate, pregnancy rate (PR).

Result(s):

There were no significant differences in fertilization rates between the two subgroups. A comparison between testicular sperm extraction (TESE) versus ejaculated sperm cycles revealed significantly higher implantation rate (20.7% vs. 5.7%), higher PR (42.5% vs. 15.1%), and higher take home baby rate (27.5% vs. 9.4%). A multivariable logistic regression analysis showed three significant predictors for pregnancy, namely the use of testicular sperm (odds ratio [OR] 5.1, 95% confidence interval [95% CI] 1.8–14.8), use of motile sperm (OR 12.9, 95% CI 2.1–79.1), and female age (OR 0.83, 95% CI 0.7–0.9).

Conclusion(s):

Testicular sperm extraction is justified in patients with cryptozoospermia who fail to conceive by ICSI using ejaculated spermatozoa, as it offers higher PR.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)00297-5/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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