Use of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with cryptozoospermia: a meta-analysis

Abstract

The existing literature does not support a recommendation for men with cryptozoospermia to use testicular sperm in preference over ejaculated sperm for ICSI.

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

“…The sperm extraction proportion from testicular and epididymis in our study was similar but fertility outcomes in PESA sub-group was significantly better than outcomes of TESE sub-group, similar to the results of Alrabeeah et al (16). In contrast to our study results, Some researchers believe that the fertilization rate of testicular extracted spermatozoa from non-obstructive azoospermic men is comparable to ejaculated spermatozoa in men with unexplained fertility and also stated that the fertilization rate of severe oligospermia or cryptozoospermia is similar to that of testicular spermatozoa source (15, 18, 19). …”

European Academy of Andrology guideline Management of oligo‐astheno‐teratozoospermia

“…In case of cryptozoospermia, based on experience showing reduced ICSI success rates when using spermatozoa from the ejaculate (Strassburger et al ., ), use of spermatozoa from TESE was reported in a retrospective study to result in higher clinical pregnancy and live birth rates (Ben‐Ami et al ., ). A recent meta‐analysis was not able to find any difference (Abhyankar et al ., ). EAA does not, generally, suggest to use testicular spermatozoa in preference over ejaculated spermatozoa of men with cryptozoospermia for ICSI.…”

Association of sperm source with miscarriage and take‐home baby after ICSI in cryptozoospermia: a meta‐analysis of testicular and ejaculated sperm

“…Several cohort studies have been conducted to clarify whether there is significant advantage of using testicular sperm over ejaculated sperm in patient with cryptozoospermia (Bendikson et al, 2008;Hauser et al, 2011;Amirjannati et al, 2012;Ben-Ami et al, 2013;Cui et al, 2016;Ketabchi, 2016), and to our knowledge there are two systematic reviews on this topic in recent years (Abhyankar et al, 2016;Kang et al, 2018). The first systematic review that was published in 2016 enrolled five studies-four cohort studies (Amirjannati et al, 2012;Ben-Ami et al, 2013;Bendikson et al, 2008;Hauser et al, 2011) and one case report (Weissman et al, 2008) (Abhyankar et al, 2016). The systematic review conducted meta-analysis from 272 ICSI cycles with 2547 transplanted embryos and concluded no differences in the pregnancy rate and fertilization rate between the two sperm sources.…”