ICSI using fresh and frozen PESA-TESA spermatozoa to examine assisted reproductive outcome retrospectively

Abstract

ObjectiveThe male reproductive system generates, accumulates, and transports the sperm. In this study, 2 methods of surgically retrieving sperm, namely, testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA), are discussed and studied in men aged ≤38 years to achieve successful conception using assisted reproductive technology. The purpose was to assess the fertilization rate (FA), clinical pregnancy, and live birth rate (LBR) with sperm.MethodsA total of 287 semen samples were divided into 4 groups as follows: fresh PESA (n=73), frozen PESA (n=65), fresh TESA (n=128), and frozen TESA (n=21). The DNA fragmentation test using sperm chromatin dispersion assay was measured and reported.ResultsFA was 70.3% and 65.5%, (P<0.022) for fresh and frozen epididymal sperm and 53.8% and 49.5%, (P<0.032) for fresh and frozen testicular sperm. LBR was 33.6% and 30.2% (P<0.075) for fresh and frozen epididymal sperm (PESA) and 22.7% and 18.2% (P<0.063) for fresh and frozen-thawed TESA sperm.ConclusionExposure to tissue shearing may adversely affect sperm quality. Increased sperm DNA damage due to long-term exposure while teasing enhances reactive oxygen species production foremost to membrane damage because of the oxidation of polyunsaturated fatty acid in lipids (lipid peroxidation), oxidation of amino acid in proteins, and inactivation of specific enzymes, all leading to enzymatic dipping and possibility of less fertilization and conception as indicated by the increase in LBR with fresh/frozen PESA compared to with fresh/frozen TESA.

Comparison of the Pregnancy and Neonatal Outcomes of ICSI Performed With Frozen Versus Fresh TESA Sperm in Patients With Obstructive Azoospermia: a Retrospective Study

“…But analogous with the results of our study, most studies have suggested a similar results in terms of fertilization rate, cleavage rate and clinical pregnancy rate in ICSI with frozen testicular sperm [12][13][14]. OU L et al [12] found that frozen testicular sperm or fresh testicular sperm extracted from patients with OA have the same 2PN fertilization and pregnancy potential (74.41% vs 76.43% and 46.81% vs 53.39%, respectively).…”

Impact on using cryopreservation of testicular or epididymal sperm upon intracytoplasmic sperm injection outcome in men with obstructive azoospermia: a systematic review and meta-analysis

“…After the screening of inclusion and exclusion criteria, 20 articles were obtained to meet the requirements (Fig. 1) [7,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The main characteristics and NOS scores of each article included in this study were shown (Table 1 and Supplementary Table S1).…”

The effect of epididymal sperm cryopreservation on neonatal birthweight following PESA-ICSI

“…During ICSI cycles using epididymal or testicular sperm, cryopreservation of retrieved sperm during diagnostic procedure for ICSI has shown to be valid option to avoid repeating puncture or biopsy. While earlier studies suggested that cycles using frozen-thawed retrieved sperm resulted in comparable pregnancy outcomes than those using fresh retrieved sperm [4,5], recent evidence suggested a lower pregnancy rate by using frozen epididymal/testicular sperm compared with fresh epididymal/testicular sperm [6,7], suggesting a potential effect of cryopreservation on injected sperm. Cryopreservation may lead to genetic and epigenetic changes in spermatozoa [8], which affect not only implantation of the transferred embryo but also neonatal outcomes of the offspring.…”