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

Liu, Hanchao; Xie, Yizhen; Linzhi, Gao; Sun, Xiankai; Liang, Xiaoyan; Deng, Chao; Gao, Yong; Liu, Guihua

doi:10.1007/s10815-020-01940-1

Cited by 17 publications

(11 citation statements)

References 48 publications

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“…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.…”

Section: Introductionmentioning

confidence: 95%

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

Cai

Liu

Chen

et al. 2021

Arch Gynecol Obstet

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Purpose: To compare the neonatal birthweight of singletons derived from ICSI cycles with fresh or frozenthawed epididymal sperm in patients with obstructive azoospermia Methods: A total of 436 singletons derived from ICSI cycles with fresh (n=220) or frozen-thawed (n=216) epididymal sperm in obstructive azoospermia evaluated from 2012 to 2018 in the retrospective study. Multivariate generalized linear model was used to analyze the association between epididymal sperm cryopreservation and neonatal birthweight.Result(s): The crude birthweight and z-score in neonates derived from frozen-thawed epididymal sperm were signi cantly lower than those from fresh epididymal sperm (3186.57g vs 3303.61g and -0.18 vs 0.08, respectively), with a mean difference of 117.04 (95%CI: 32.36 to 201.72) g and 0.25 (95%CI: 0.06 to 0.45). Adjusted for confounders including parental age and BMI, maternal ovarian reserve, paternal FSH and T levels, peak E2 during OPU cycles, frozen-thawed embryo transfer, embryo development stage, gestational age, maternal parity and child gender, the multivariate model suggested that singletons conceived from ICSI with fresh epididymal sperm was on average 91.21 g heavier than those conceived from ICSI with frozen-thawed epdidiymal sperm (95%CI:12.72 to 166.7, P=0.016). Conclusion(s): Cryopreservation of epididymal sperm may negatively affect birthweight

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Section: Introductionmentioning

confidence: 95%

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

Cai

Liu

Chen

et al. 2021

Arch Gynecol Obstet

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“…Firstly, the sample size was too small to divide subgroups for independent analysis of the use of fresh and frozen-thawed spermatozoa. However, no statistical differences were found in the fertilization and good quality embryo rates between the frozen-thawed immotile spermatozoa group and the routine fresh immotile spermatozoa ICSI group [35]. Larger samples are needed to compare the clinical outcomes of these two subgroups.…”

Section: Discussionmentioning

confidence: 93%

Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies

Chen

Wang

Zhou

et al. 2021

Preprint

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Background Azoospermic patients have benefited from both epididymal and testicular spermatozoa intracytoplasmic sperm injection (ICSI) treatment and lasers have been used to identify viable but immotile spermatozoa before the procedure. However, there are limited studies on the safety of laser-assisted selection of immotile spermatozoa. The aim of this study was to investigate the impact of laser-assisted selection of immotile spermatozoa on the obstetric and neonatal outcomes after ICSI. Methods A retrospective comparative study was conducted on patients who underwent ICSI treatment with testicular spermatozoa in our Reproductive Medicine Unit from June 2014 to June 2018. The 132 cycles were divided into two groups according to whether laser-assisted selection of spermatozoa was used. Results Compared with control group, no significant differences were found in the pregnancy, implantation, miscarriage and live birth rates in the laser group in either fresh or frozen transfer cycles. The cumulative live birth rate in the laser group was 69.70%, which was slightly higher than in the control group (60.61%), but this was not statistically different. There were no differences in the average gestational age, premature birth rate, neonatal birth weight and the malformation rate between the laser and control groups (P > 0.05). In addition, the obstetric outcome between the two groups were not different (P > 0.05). Conclusions No negative effect on perinatal and neonatal outcomes was seen by using laser-assisted selection of immotile spermatozoa for TESA-ICSI. This study endorses the use of laser-assisted selection of viable spermatozoa for ICSI cycles.

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“…High-quality blastocysts are usually able to achieve higher pregnancy and implantation rates, which are important indicators of the developmental potential of transferred embryos in vivo (24). With regard to the effect of sperm from different surgical sources on pregnancy outcomes in assisted reproduction, some authors (25,26) have concluded that there is no significant difference in the effect of testicular and epididymal sperm on clinical pregnancy rates and miscarriage rates. The results of this study showed that the rate of high-quality blastocysts in the TESA group was 82.56%, which was significantly higher than that in the PESA group (71.82%).The higher rate of highquality blastocysts in the TESA group may be due to the fact that the sperm obtained by the TESA procedure were local fresh sperm from the testicular tissue, while the patients in the PESA group may have had a poor sperm storage microenvironment due to long vasal obstruction, resulting in The results of most domestic and international studies (27,28) showed no statistical difference in the fertilization rate, high-quality embryo rate, miscarriage rate, and ectopic pregnancy rate between TESA and PESA surgical sperm sources.…”

Section: Discussionmentioning

confidence: 99%

Comparative Clinical Study of Percutaneous Epididymal Sperm Aspiration and Testicular Biopsy in the Outcome of ICSI-Assisted Fertility Treatment in Patients with Obstructive Azoospermia

Liao

et al. 2022

Front. Surg.

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ObjectiveTo compare and contrast the effects of percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA) on the outcome of intracytoplasmic sperm injection (ICSI)-assisted fertility treatment in patients with obstructive azoospermia.MethodsPatients with obstructive azoospermia with an age distribution of 20–36 years admitted to the male department of the Reproductive Center of the Second Affiliated Hospital of South China University (Hengyang Nanhua Xing Hui Reproductive Health Hospital) from December 2018 to December 2020 were used in this study. One group was set up as the PESA group to perform PESA, and the other group was set up as the TESA group to perform percutaneous testicular biopsy for sperm extraction. Patients who were unsuccessful in PESA continued to undergo TESA, and if sperm were retrieved, they were classified as the TESA group. General information on male patients and their partners was collected and compared in patients from different sperm source groups. Embryo development (normal fertilization rate, high-quality embryo rate, and high-quality blastocyst rate) and pregnancy outcome (clinical pregnancy rate, miscarriage rate, and ectopic pregnancy rate) were compared between the two groups.ResultsFinally, there were 26 patients in the PESA group and 31 patients in the TESA group. There were no significant differences in terms of age, years of infertility, testosterone level, (FSH) follicle-stimulating hormone level, and testicular volume between the male patients in the PESA and TESA groups of two different sperm sources, and no significant differences were found in the general conditions of the female patients in terms of age, number of eggs obtained, number of sinus follicles, basal FSH value, and basal E2 value (p > 0.05). The rate of high-quality blastocysts in the TESA group was significantly higher than that in the PESA group (p < 0.05); the differences in clinical normal fertilization rate, high-quality embryo rate, clinical pregnancy rate, miscarriage rate, and ectopic pregnancy rate between the two groups were not statistically significant (p > 0.05).ConclusionICSI with different sources of sperm in patients with male factor infertility alone, which had no significant effect on embryo development, embryo implantation rate, clinical pregnancy rate, and miscarriage rate, resulting in better clinical outcomes.

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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

Abstract: Purpose To determine whether there was a significant impact on using cryopreservation of testicular or epididymal sperm upon the outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia (OA).

Cited by 17 publications

References 48 publications

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

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

Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies

Comparative Clinical Study of Percutaneous Epididymal Sperm Aspiration and Testicular Biopsy in the Outcome of ICSI-Assisted Fertility Treatment in Patients with Obstructive Azoospermia

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