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Intracytoplasmic Sperm Injection Outcomes with Freshly Ejaculated Sperms and Testicular or Epididymal Sperm Extraction in Patients with Idiopathic Cryptozoospermia

View Article: PubMed Central - PubMed

ABSTRACT

Background: Cryptozoospermia (CO) is a situation in which spermatozoa cannot be observed in a fresh semen sample unless an extended centrifugation and microscopic search are performed. CO patients are suggested to use only intracytoplasmic sperm injection (ICSI) as infertility treatment. But still there is debate about the choice of sperm source in cryptozoospermic men candidate for ICSI.

Objectives: This study was conducted to evaluate fertility outcomes in men with idiopathic cryptozoospermia who were treated using ICSI with freshly ejaculated sperm and testis sperm extraction (TESE) or percutaneous epididymal sperm aspiration (PESA).

Methods: In this prospective cohort study carried out in an academic institution, 83 out of 92 couples with cryptozoospermia undergoing their first ICSI cycle were recruited. These patients were randomly allocated to two groups: group one (n = 42) who produced freshly ejaculated sperm and, group two (n = 41) who produced a sample by TESE or PESA. The groups were analyzed and compared in terms of fertilization rate, cleavage rate, embryo quality, implantation rate, and clinical pregnancy rate.

Results: There was a significant difference in fertilization rate, embryo quality, implantation rate, and pregnancy rates between the group of surgically extracted sperm and those of naturally ejaculated sperm using conventional ICSI (P < 0.05).

Conclusions: Sperm quality extracted by percutaneous PESA and TESE procedures increases fertility outcomes compared to naturally ejaculated sperm in men with idiopathic CO. More specifically, embryo quality, which is most relevant to fertility outcome, improved when surgically extracted sperm was used for ICSI.

No MeSH data available.


Fertility Outcome in PESA vs. TESE Sub Groups
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fig39286: Fertility Outcome in PESA vs. TESE Sub Groups

Mentions: Seventy-three men with idiopathic cryptozoospermia (< 103 spermatozoa/ml) were randomly allocated to two groups in a 1:1 fashion. Group one (n = 38) used freshly ejaculated sperm and group two (n = 35) had sperm obtained from extraction via epididymis (n = 18) or testis (n = 17). All patients in both groups had idiopathic oligoasthenospermia and there was no significant difference in age, duration of infertility, and type of infertility (Table 1). Table 1 demonstrates the comparison of pregnancy outcomes between two groups. There were significant differences in fertilization rate, embryo quality rate, implantation rate, and pregnancy rate between the groups. In group 2, 18 patients (51.42%) with PSEA and 17 (48.57%) with TESE were also significantly different in fertility outcomes (P > 0.05). The PESA sub-group outcomes were significantly better than those of TESE, particularly in terms of pregnancy rate and embryo quality rate (P < 0.05) (Figure 1).


Intracytoplasmic Sperm Injection Outcomes with Freshly Ejaculated Sperms and Testicular or Epididymal Sperm Extraction in Patients with Idiopathic Cryptozoospermia
Fertility Outcome in PESA vs. TESE Sub Groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120410&req=5

fig39286: Fertility Outcome in PESA vs. TESE Sub Groups
Mentions: Seventy-three men with idiopathic cryptozoospermia (< 103 spermatozoa/ml) were randomly allocated to two groups in a 1:1 fashion. Group one (n = 38) used freshly ejaculated sperm and group two (n = 35) had sperm obtained from extraction via epididymis (n = 18) or testis (n = 17). All patients in both groups had idiopathic oligoasthenospermia and there was no significant difference in age, duration of infertility, and type of infertility (Table 1). Table 1 demonstrates the comparison of pregnancy outcomes between two groups. There were significant differences in fertilization rate, embryo quality rate, implantation rate, and pregnancy rate between the groups. In group 2, 18 patients (51.42%) with PSEA and 17 (48.57%) with TESE were also significantly different in fertility outcomes (P > 0.05). The PESA sub-group outcomes were significantly better than those of TESE, particularly in terms of pregnancy rate and embryo quality rate (P < 0.05) (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Cryptozoospermia (CO) is a situation in which spermatozoa cannot be observed in a fresh semen sample unless an extended centrifugation and microscopic search are performed. CO patients are suggested to use only intracytoplasmic sperm injection (ICSI) as infertility treatment. But still there is debate about the choice of sperm source in cryptozoospermic men candidate for ICSI.

Objectives: This study was conducted to evaluate fertility outcomes in men with idiopathic cryptozoospermia who were treated using ICSI with freshly ejaculated sperm and testis sperm extraction (TESE) or percutaneous epididymal sperm aspiration (PESA).

Methods: In this prospective cohort study carried out in an academic institution, 83 out of 92 couples with cryptozoospermia undergoing their first ICSI cycle were recruited. These patients were randomly allocated to two groups: group one (n = 42) who produced freshly ejaculated sperm and, group two (n = 41) who produced a sample by TESE or PESA. The groups were analyzed and compared in terms of fertilization rate, cleavage rate, embryo quality, implantation rate, and clinical pregnancy rate.

Results: There was a significant difference in fertilization rate, embryo quality, implantation rate, and pregnancy rates between the group of surgically extracted sperm and those of naturally ejaculated sperm using conventional ICSI (P &lt; 0.05).

Conclusions: Sperm quality extracted by percutaneous PESA and TESE procedures increases fertility outcomes compared to naturally ejaculated sperm in men with idiopathic CO. More specifically, embryo quality, which is most relevant to fertility outcome, improved when surgically extracted sperm was used for ICSI.

No MeSH data available.