Intracytoplasmic spermatid injection and in vitro maturation: fact or fiction?

Abstract

Intracytoplasmic injection with testicular spermatozoa has become a routine treatment in fertility clinics. Spermatozoa can be recovered in half of patients with nonobstructive azoospermia. The use of immature germ cells for intracytoplasmic injection has been proposed for cases in which no spermatozoa can be retrieved. However, there are low pregnancy rates following intracytoplasmic injection using round spermatids from men with no elongated spermatids or spermatozoa in their testes. The in vitro culture of immature germ cells to more mature stages has been proposed as a means to improve this poor outcome. Several years after the introduction of intracytoplasmic injection with elongating and round spermatids, uncertainty remains as to whether this approach can be considered a safe treatment option. This review outlines the clinical and scientific data regarding intracytoplasmic injection using immature germ cells and in vitro matured germ cells.

Nonobstrüktif Azospermi Olgularında Yeni Yaklaşımlar

“…Nonobstrüktif azospermide histolojik olarak ya germ hücre aplazisi, matürasyon arresti ya da tübüler skleroz ve atrofi görülür. (4). Nonobstruktif azospermide genellikle testisler küçük boyutta ve yumuşaktır.…”

“…Genel olarak mikroTESE işlemi sonucu nonobstrüktif azospermi olgularında sperm elde etme başarısının %41. 4 (4). Geçmişten günümüze kadar kültür şartlarında önemli ilerlemeler olmasına rağmen optimize kültür şartları halen bilinmemektedir.…”

“…Azospermi semende hiç sperm bulunamaması durumudur. Erkek nüfusunun yaklaşık %1'inde ve erkek infertilitesine sahip hastaların %10-15' de bulunur (4). Azospermi teşhisi koymak için, ilk analizden bir ay sonra testi tekrarlamak gerekir.…”

Ninety babies born after round spermatid injection into oocytes: survey of their development from fertilization to 2 years of age

“…The process is referred to as round spermatid injection (ROSI). Although the birth of several ROSI babies was reported by Tesarik et al (3) and others (4,5), some investigators questioned the value of ROSI owing to its low efficiency (6)(7)(8).…”

The azoospermic male: current knowledge and future perspectives

“…We conclude that for now, the limited evidence on pregnancy and postnatal outcomes of ICSI using surgically derived sperm from azoospermic men is reassuring; however, a call for continuous monitoring is of utmost importance to support the recommendation of sperm retrieval and ICSI in azoospermia-related male infertility. Following this theme, an authoritative review by Dr. Veerle and co-authors provides an analysis of the results of immature germ cells used for ICSI (16). This strategy has been proposed in cases of NOA in which no spermatozoa can be retrieved.…”