Sandro C Esteves1, Fernando Sánchez-Martín2, Pascual Sánchez-Martín2, Danielle T Schneider3, Jaime Gosálvez4. 1. Androfert, Andrology and Human Reproduction Clinic, Campinas, Brazil. Electronic address: s.esteves@androfert.com.br. 2. Ginemed, Seville, Spain. 3. Androfert, Andrology and Human Reproduction Clinic, Campinas, Brazil. 4. Unit of Genetics, Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.
Abstract
OBJECTIVE: To investigate the effectiveness of intracytoplasmic sperm injection (ICSI) using testicular sperm as a strategy to overcome infertility in men with high sperm DNA fragmentation (SDF). DESIGN: Prospective, observational, cohort study. SETTING: Private IVF centers. PATIENT(S): A total of 147 couples undergoing IVF-ICSI and day 3 fresh ETs whose male partner has oligozoospermia and high SDF. INTERVENTION(S): Sperm injections were carried out with ejaculated sperm (EJA-ICSI) or testicular sperm (TESTI-ICSI) retrieved by either testicular sperm extraction (TESE) or testicular sperm aspiration (TESA). SDF levels were reassessed on the day of oocyte retrieval in both ejaculated and testicular specimens. MAIN OUTCOME MEASURE(S): Percentage of testicular and ejaculated spermatozoa containing fragmented DNA (%DFI) and clinical pregnancy, miscarriage, and live-birth rates. RESULT(S): The %DFI in testicular sperm was 8.3%, compared with 40.7% in ejaculated sperm. For the TESTI-ICSI group versus the EJA-ICSI group, respectively, the clinical pregnancy rate was 51.9% and 40.2%, the miscarriage rate was 10.0% and 34.3%, and the live-birth rate was 46.7% and 26.4%. CONCLUSION(S): ICSI outcomes were significantly better in the group of men who had testicular sperm used for ICSI compared with those with ejaculated sperm. SDF was significantly lower in testicular specimens compared with ejaculated counterparts. Our results suggest that TESTI-ICSI is an effective option to overcome infertility when applied to selected men with oligozoospermia and high ejaculated SDF levels.
OBJECTIVE: To investigate the effectiveness of intracytoplasmic sperm injection (ICSI) using testicular sperm as a strategy to overcome infertility in men with high sperm DNA fragmentation (SDF). DESIGN: Prospective, observational, cohort study. SETTING: Private IVF centers. PATIENT(S): A total of 147 couples undergoing IVF-ICSI and day 3 fresh ETs whose male partner has oligozoospermia and high SDF. INTERVENTION(S): Sperm injections were carried out with ejaculated sperm (EJA-ICSI) or testicular sperm (TESTI-ICSI) retrieved by either testicular sperm extraction (TESE) or testicular sperm aspiration (TESA). SDF levels were reassessed on the day of oocyte retrieval in both ejaculated and testicular specimens. MAIN OUTCOME MEASURE(S): Percentage of testicular and ejaculated spermatozoa containing fragmented DNA (%DFI) and clinical pregnancy, miscarriage, and live-birth rates. RESULT(S): The %DFI in testicular sperm was 8.3%, compared with 40.7% in ejaculated sperm. For the TESTI-ICSI group versus the EJA-ICSI group, respectively, the clinical pregnancy rate was 51.9% and 40.2%, the miscarriage rate was 10.0% and 34.3%, and the live-birth rate was 46.7% and 26.4%. CONCLUSION(S): ICSI outcomes were significantly better in the group of men who had testicular sperm used for ICSI compared with those with ejaculated sperm. SDF was significantly lower in testicular specimens compared with ejaculated counterparts. Our results suggest that TESTI-ICSI is an effective option to overcome infertility when applied to selected men with oligozoospermia and high ejaculated SDF levels.
Authors: Filipe Tenorio Lira Neto; Phil Vu Bach; Bobby Baback Najari; Philip Shihua Li; Marc Goldstein Journal: Curr Urol Rep Date: 2016-10 Impact factor: 3.092
Authors: Sandro C Esteves; Armand Zini; Robert Matthew Coward; Donald P Evenson; Jaime Gosálvez; Sheena E M Lewis; Rakesh Sharma; Peter Humaidan Journal: Andrologia Date: 2020-10-27 Impact factor: 2.775
Authors: Rafael F Ambar; Ashok Agarwal; Ahmad Majzoub; Sarah Vij; Nicholas N Tadros; Chak Lam Cho; Neel Parekh; Edson Borges; Sidney Glina Journal: World J Mens Health Date: 2020-06-25 Impact factor: 5.400
Authors: Ashok Agarwal; Rakesh Sharma; Sajal Gupta; Renata Finelli; Neel Parekh; Manesh Kumar Panner Selvam; Ralf Henkel; Damayanthi Durairajanayagam; Camila Pompeu; Sarah Madani; Andrea Belo; Neha Singh; Simryn Covarrubias; Sara Darbandi; Raha Sadeghi; Mahsa Darbandi; Paraskevi Vogiatzi; Florence Boitrelle; Mara Simopoulou; Ramadan Saleh; Mohamed Arafa; Ahmad Majzoub; Hussein Kandil; Armand Zini; Edmund Ko; Juan G Alvarez; Marlon Martinez; Jonathan Ramsay; Sunil Jindal; Gian Maria Busetto; Hassan Sallam; Israel Maldonado; Christina Anagnostopoulou; Marco G Alves; Pallav Sengupta; Kambiz Gilany; Donald P Evenson; Sheena E M Lewis; Jaime Gosalvez; Rafael F Ambar; Rupin Shah Journal: World J Mens Health Date: 2021-06-17 Impact factor: 6.494