Abstract
Purpose:Our purpose was to evaluate whether the source of spermatozoa influences the results of intracytoplasmic sperm injection (ICSI) treatment in couples with severe malefactor infertility.
Methods:A retrospective analysis of 40 cases of ICSI with testicular-retrieved spermatozoa, matched with 40 cases of ICSI with ejaculated spermatozoa, was performed. We included only couples with normoovulatory females younger than 37 years who were matched according to the day of ovum pickup with the patients in the study group.
Results:Eighty cycles were analyzed: 40 cycles using testicular spermatozoa and 40 cycles using ejaculated spermatozoa. In 32 (80%) of the 40 ICSI transcutaneous needle aspiration cycles, we obtained enough spermatozoa to inject all the mature oocytes retrieved. In eight (20%) cases there were not enough spermatozoa to inject all the oocytes. Only 76 (54%) of 141 available oocytes were injected in these eight patients. The oocyte fertilization rates were 42% for the study group and 55.5% for the controls (P < 0.005). Thirty-six (90%) patients in the group with nonobstructive a zoospermia (NOA) and 37 (92.5%) patients in the oligoteratoasthenospermia (OTA) group had embryos for replacement. The mean cleavage rates per cycle (96% with tasticular and 93% with ejaculated spermatozoa), the mean number of embryos per transfer (3.72 ± 1.6 in the NOA group and 4.24 ±1.5 in the OTA group), the embryo quality (cumulative embryo scoring = 34.03 ± 22.62 in the testicular sperm group and 36.08 ± 19.28 in the ejaculated sperm group), and the clinical pregnancy rates (22.5% in the NOA patients and 20% in the ejaculate group) were not significantly different between groups.
Conclusions:High fertilization, cleavage, and pregnancy rates can be achieved with intracytoplasmic testicular sperm injection from patients with NOA, reaching levels comparable with those of ICSI using ejaculated spermatozoa.
Keywords: intracytoplasmic sperm injection, infertility, male factor
Full Text
The Full Text of this article is available as a PDF (395.9 KB).
REFERENCES
- 1.Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340:17–18. doi: 10.1016/0140-6736(92)92425-f. [DOI] [PubMed] [Google Scholar]
- 2.Nagy ZP, Liu J, Joris H, Verheyen G, Tournaye H, Camus M, Derde M-P, Devroey P, Van Steirteghem AC. The results of intracytoplasmic sperm injection is not related to any of the three basic sperm parameters. Hum Reprod. 1995;10:1123–1129. doi: 10.1093/oxfordjournals.humrep.a136104. [DOI] [PubMed] [Google Scholar]
- 3.Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus M, Van Steirteghem AC. Pregnancies after testicular sperm extraction and intracytoplasmic sperm extraction in nonobstructive azoospermia. Hum Reprod. 1995;10:1457–1460. doi: 10.1093/humrep/10.6.1457. [DOI] [PubMed] [Google Scholar]
- 4.Madjar I, Seidman DS, Levran D, Yonish M, Augarten A, Yemini Z, Mashiach S, Dor J. Micromanipulation improves in vitro fertilization results after epididymal or testicular sperm aspiration in patients with congenital absence of the vas deferens. Hum Reprod. 1996;11:2151–2154. doi: 10.1093/oxfordjournals.humrep.a019067. [DOI] [PubMed] [Google Scholar]
- 5.Schoysman R, Vanderzwalmen P, Nijs M, Sigal L, Sigal-Bertin J, Geerts L, van Roosendaal E, Schoysman D. Pregnancy after fertilization with human testicular spermatozoa. Lancet. 1993;342:1237. doi: 10.1016/0140-6736(93)92217-h. [DOI] [PubMed] [Google Scholar]
- 6.Nagy ZP, Liu J, Janssenwillen C, Silber S, Devroey P, Van Steirteghem AC. Using ejaculated, fresh, and frozen-thawed epididymal and testicular spermatozoa gives rise to comparable results after intracytoplasmic sperm injection. Fertil Steril. 1995;63:808–815. doi: 10.1016/s0015-0282(16)57486-x. [DOI] [PubMed] [Google Scholar]
- 7.Shulman A, Ben-Nun I, Ghetler Y, Kaneti H, Shilon M, Beyth Y. Relationship between embryo morphology and implantation rate after in vitro fertilization treatment in conception cycles. Fertil Steril. 1993;60:123–126. doi: 10.1016/s0015-0282(16)56048-8. [DOI] [PubMed] [Google Scholar]
- 8.Dor J, Ben Shlomo S, Lipitz S. Ovarian stimulation with gonadotropin releasing hormone (GnRH) analogue improves the in vitro fertilisation (IVF) pregnancy rate with both transvaginal and laparoscopic oocyte recovery. J In Vitro Fert Embryo Transfer. 1990;7:351–354. doi: 10.1007/BF01130589. [DOI] [PubMed] [Google Scholar]
- 9.Silber SJ, Van Steirteghem AC, Liu J, Nagy Z, Tournaye H, Devroey P. High fertilization and pregnancy rate after intracytoplasmic sperm injection with spermatozoa obtained from testicle biopsy. Hum Reprod. 1995;10:148–152. doi: 10.1093/humrep/10.1.148. [DOI] [PubMed] [Google Scholar]
- 10.Nijs M, Vanderzwalmen P, Vandamme B, Segal-Bertin G, Lejeune B, Segal L, van Roosetdaal E, Schoysman R. Fertilizing ability of immotile spermatozoa after intracytoplasmic sperm injection. Hum Reprod. 1996;11:2180–2185. doi: 10.1093/oxfordjournals.humrep.a019073. [DOI] [PubMed] [Google Scholar]