Table 2. Characteristics and main outcome measures of studies reporting ICSI outcomes with testicular versus ejaculated sperm in non-azoospermic men with severe oligozoospermia/cryptozoospermia.
| Study characteristics | Indication | Sperm retrieval method | Outcomes | |||||
|---|---|---|---|---|---|---|---|---|
| Author (year) | Design | Subjects and cohort size (N) | SDF
assessment |
Sperm
retrieval method |
Sperm retrieval
success and complication rates (%) |
Fertilization rate (%) | Clinical
pregnancy rate (%) |
Live birth rate (%) |
| Weissman
et al. 35 (2008) |
Case series | Severe oligozoospermic (<5 million/mL)
infertile men (4) undergoing Testi-ICSI; couples with a history of multiple failed ICSI cycles with ejaculated sperm; in total, five TESA-ICSI cycles were carried out in the cohort of four patients |
No | TESA | 100.0 and NR | 67.6 | 75.0 | 75.0 |
| Bendikson
et al. 36 (2008) |
Case series | Cryptozoospermic infertile men (16);
couples with history of IVF/ICSI failure (16) with ejaculated sperm; in total, 21 TESA-ICSI cycles were carried out in the cohort of 16 patients |
No | Micro-TESE | 100.0 and NR | 51.7 (T) vs. 59.9 (E)
(NS) |
20.8 (E) vs. 47.4
(T) (NS) |
20.8 (E) vs. 42.1
(T) (NS) |
| Hauser
et al.
37
(2011) |
Prospective
cohort |
Cryptozoospermic infertile men (13); in
total, 93 ICSI cycles (ICSI with ejaculated sperm, n = 34; ICSI with fresh testicular sperm, n = 9; ICSI with frozen-thawed testicular sperm, n = 50) were carried out in the cohort of 13 patients |
No | TESE | 100.0 and NR | 38.2 (E) vs. 50.0
(T, fresh) vs. 46.7 (T, frozen-thawed) a ( P <0.05, pairwise comparisons between T and E sperm) |
14.3 (E) vs. 42.9
(T, fresh) vs. 12.8 (T, frozen- thawed) (NS) |
14.3 (E) vs. 42.9
(T, fresh) vs. 12.8 (T, frozen-thawed) (NS) |
| Ben-Ami
et al. 39 (2013) |
Case series | Cryptozoospermic (17) infertile men;
couples with multiple failed ICSI cycles using ejaculated sperm; in total, 116 ICSI cycles (Testi-ICSI, n = 48; Ejac-ICSI, n = 68) were carried out in the cohort of 16 patients |
No | TESE | 100.0 and NR | 38.0 (E) vs. 46.7 (T)
(NS) |
15.1 (E) vs. 42.5
(T) ( P = 0.004) |
9.4 (E) vs. 27.5 (T)
( P = 0.028) |
| Ketabchi
41 (2016) |
Prospective
cohort |
Cryptozoospermic (<10
3 sperm/mL)
infertile men (73) undergoing ICSI with sperm retrieved from the epididymis or testis (18) |
No | PESA and
TESE |
100.0 and NR | 55.3 (E) vs. 85.7.
(T+E) ( P <0.001) |
31.6 (E) vs. 57.1
(T) ( P <0.001) |
NR |
| Cui
et al.
42
(2017) |
Retrospective
cohort |
Cryptozoospermic infertile men
undergoing Testi-ICSI; couples (285) undergoing ICSI with ejaculated sperm (214) or testicular sperm (71) |
No | TESA and
TESE |
97.9 and NR | 59.6 (E) vs. 60.6 (T)
(NS) |
33.3 (E) vs. 53.6
(T) ( P <0.01) |
27.1 (E) vs. 44.0
(T) ( P = 0.03) |
| Yu
et al.
45 (2019) |
Retrospective
cohort |
Cryptozoospermic infertile men (35)
undergoing Testi-ICSI; in total, 19 cycles (18 patients) were performed with ejaculated sperm and 19 cycles (17 patients) with testicular sperm |
No | TESA and
micro-TESE |
100.0 and NR | 74.7 (E) and 62.4 (T)
in men <35 years old ( P = 0.01); 60.9 (E) and 56.6 (T) in men ≥35 years old (NS) |
74.7 (E) and
62.4 (T) in men <35 years old ( P = 0.01); 60.9 (E) and 56.6 (T) in men ≥35 years old (NS) |
44.4 (E) and 52.9
(T) in men <35 years old (NS); 0.0 (E) and 42.9 (T) in men ≥35 years old |
a2PN fertilization using motile sperm. E, ejaculated sperm group; Ejac-ICSI, intracytoplasmic sperm injection with ejaculated sperm; LBR, live birth rate; micro-TESE, microdissection testicular sperm extraction; NR, not reported; NS, not significantly different; OPR, ongoing pregnancy rate; SDF, sperm DNA fragmentation; T, testicular sperm group; TESA, testicular sperm aspiration; TESE, Testicular sperm extraction, Testi-ICSI, intracytoplasmic sperm injection with testicular sperm.