Testicular sperm aspiration (TESA) for infertile couples with severe or complete asthenozoospermia
- 10 February 2017
- Vol. 5 (2), 226-231
- https://doi.org/10.1111/andr.12317
Abstract
The aim of the study was to evaluate reproductive outcomes in a cohort of infertile couples with severe and complete asthenozoospermia undergoing TESA (testicular sperm aspiration) with ICSI. We conducted a retrospective study of 28 couples with complete or severe asthenozoospermia who underwent TESA between January 2010 and December 2015. We compared TESA-ICSI outcomes of these couples to ejaculate ICSI outcomes of 40 couples with severe asthenozoospermia treated during the same time period at our institution. Couples with female factor infertility and/or female aged ≥39 were excluded. Sperm retrieval rates and ICSI outcomes [(MII oocytes, fertilization rate, good embryo rate (transferred and frozen), couples with embryo transfer (per cycle started), clinical pregnancy (per embryo transfer)] were recorded. Patients were grouped based on whether they had ejaculated (Ej-group) or testicular (TESA-group) spermatozoa used. Testicular sperm patients were further classified based on whether they had complete asthenozoospermia (0% total motility) (Tc-group) or severe asthenozoospermia (≤1% progressive motility) (Ts-group). Mean (±SD) male and female ages were 36 ± 6 and 32 ± 4, respectively. Sperm recovery by testicular sperm aspiration (TESA) was successful in 100% (28/28) of the men. The overall clinical pregnancy rate (CPR) per cycle started was 34% (23/68) with a mean of 1.1 ± 0.4 embryos transferred per transfer. Fertilization rates were significantly lower in TESA-group compared to Ej-group (52% vs. 67%, respectively; p = 0.001), while male age was significantly higher in TESA-group compared to Ej-group (34 ± 6 vs. 37 ± 6, respectively; p = 0.03). Moreover, female age was significantly higher in Tc-group compared to Ts-group (30 ± 4 vs. 33 ± 3, respectively; p = 0.0285). However, there were no significant difference in clinical pregnancy rate per embryo transfer in the Tc-group, Ts-group, and Ej-group (50% vs. 45% vs. 57%, respectively; p = 0.8219). The data suggest that testicular sperm-ICSI is no better than ejaculated sperm-ICSI in couples with severe or complete asthenozoospermia. Randomized, controlled trials comparing ejaculated vs. testicular spermatozoa are needed to assess the true benefit of TESA-ICSI in these couples.Keywords
This publication has 28 references indexed in Scilit:
- Which isolated sperm abnormality is most related to sperm DNA damage in men presenting for infertility evaluationJournal of Assisted Reproduction and Genetics, 2014
- Relationship between Testicular Volume and Conventional or Nonconventional Sperm ParametersInternational Journal of Endocrinology, 2013
- High prevalence of isolated sperm DNA damage in infertile men with advanced paternal ageJournal of Assisted Reproduction and Genetics, 2013
- A comparison of ejaculated and testicular spermatozoa aneuploidy rates in patients with high sperm DNA damageSystems Biology in Reproductive Medicine, 2012
- Sperm chromatin structure assay parameters are not related to fertilization rates, embryo quality, and pregnancy rates in in vitro fertilization and intracytoplasmic sperm injection, but might be related to spontaneous abortion ratesFertility and Sterility, 2008
- Chronic epididymitis: impact on semen parameters and therapeutic optionsAndrologia, 2008
- Frequency of aneuploidy in sperm from patients with extremely severe male factor infertilityHuman Reproduction, 2005
- Pregnancies achieved with testicular and ejaculated spermatozoa in combination with intracytoplasmic sperm injection in men with totally or initially immotile spermatozoa in the ejaculateHuman Reproduction, 1996
- Analysis of 76 total fertilization failure cycles out of 2732 intracytoplasmic sperm injection cyclesHuman Reproduction, 1995
- Andrology: Mitochondrial disease and reduced sperm motilityHuman Reproduction, 1993