Selective use of percutaneous testis biopsy to optimize IVF-ICSI outcomes: a case series

Abstract

BackgroundSperm quality may degrade during transit through the male reproductive tract in some individuals. In this setting surgically retrieved testicular sperm may outperform ejaculated samples for use with in vitro fertilization (IVF) and intracytoplasmic sperm injection (IVF-ICSI). We sought to describe one center’s experience with the use of fresh testicular sperm after prior failed IVF-ICSI with ejaculated samples.ResultsA retrospective review was conducted evaluating IVF-ICSI cycles performed at a tertiary IVF unit between 2009 and 2014. Couples who were managed with percutaneous testis biopsy to obtain sperm, despite availability of ejaculated sperm, were included. Four couples who underwent a total of 6 percutaneous testis biopsy/IVF-ICSI cycles were identified. Collectively, the couples had undergone 9 prior IVF-ICSI cycles using fresh ejaculated sperm without successful pregnancy. From the six cycles that used fresh testicular sperm four live births resulted (1 twin gestation, 3 singletons). Only 1 of the 4 couples remained childless.ConclusionsFor patients who have had prior failed IVF-ICSI attempts, this small case series demonstrates a possible therapeutic benefit when freshly procured testicular sperm are used in lieu of ejaculated samples.

DNA fragmentation in epididymal freeze-dried ram spermatozoa impairs embryo development

“…Our embryo developmental rate is comparable to the results achieved previously in these domestic species. Several human pathologies cause a requirement for the exclusive use of epidydimal spermatozoa [ 31 ]. This work can give a likely opportunity to expand the application of the lyophilization field in that direction.…”

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

“…reactive oxygen species). Also, some preliminary researches have shown the sperm may damage when passing through the male reproductive tract by decreasing the quality of sperms in terms of DNA integrity (6, 20, 21). We demonstrated that the surgically extracted sperm will do better than ejaculated sperm in ICSI and improve pregnancy outcomes in men with idiopathic cryptozoospermia.…”

“…Testicular or epididymal sperm retrieval procedures are available options when the outcome of fertilization by ejaculated sperms is not favorable or when no clinical pregnancy is achieved after multiple attempts with ejaculated fresh sperm cells (6). When both sources of spermatozoa are available (i.e.…”