Outcome of intracytoplasmic sperm injection cycles with fresh testicular spermatozoa obtained on the day of or the day before oocyte collection and with cryopreserved testicular sperm in patients with azoospermia.

To compare the outcome of intracytoplasmic sperm injection (ICSI)-ET cycles with fresh testicular spermatozoa obtained on the same day or the day before oocyte retrieval with frozen-thawed spermatozoa. Retrospective cohort study. Fertility center. The first ICSI-ET cycle of 337 couples with motile testicular spermatozoa of azoospermic patients. Microdissection testicular sperm extraction (TESE), sperm cryopreservation, ICSI-ET. Fertilization, implantation, clinical pregnancy rates (PRs) and delivery rates. Testicular sperm retrieval was performed on the day of oocyte retrieval in 166 cycles (group A), the day before oocyte retrieval in 42 cycles (group B), and the frozen-thawed testicular spermatozoa were used in 129 cycles (group C). The groups were comparable in terms of the ages of male and female patients, ovarian response to stimulation, as well as the number of oocytes injected. The number of cycles with nonobstructive azoospermia and obstructive azoospermia was evenly distributed in each group. Fertilization rates were 70.7%, 68.7%, and 67.3%, clinical PRs 31.3%, 30.9%, and 25.5%, and delivery rates 28.9%, 28.5%, and 23.2% for groups A, B, and C, respectively. The outcomes of patients with nonobstructive azoospermia did not differ from those of patients with obstructive azoospermia within and among the groups. Neither the timing of TESE (on the day of or the day before oocyte retrieval) nor the use of frozen-thawed testicular sperm affects the outcome of ICSI-ET cycle when motile spermatozoa are obtained in azoospermic men. In addition, etiology of azoospermia does not have any influence on the outcome with different timing of microdissection TESE procedure for ICSI.

Karacan M ，Alwaeely F ，Erkan S ，Çebi Z ，Berberoğlugil M ，Batukan M ，Uluğ M ，Arvas A ，Çamlıbel T ... -  《-》

The effect of advanced paternal age on the outcomes of assisted reproductive techniques among patients with azoospermia using cryopreserved testicular spermatozoa.

To determine whether advanced male age influences the outcome of intracytoplasmic sperm injection (ICSI) following the cryopreservation of spermatozoa obtained through testicular sperm extraction (TESE). Data were collected from infertile couples suffering from azoospermia who underwent TESE and ICSI from January 1998 to August 2010. There were 212 ICSI cycles using extracted testicular sperm after cryopreservation in this retrospective clinical analysis. The participating men all underwent testicular biopsy and subsequent tissue cryopreservation in a single academic tertiary care medical center. Those cryopreserved sperm were used during consecutive intracytoplasmic sperm injection treatment cycles. Female partners underwent individualized controlled ovarian hyperstimulation programs. A total of 184 ICSI cycles were divided into the following two evaluation designs: (1) total cycles irrespective maternal age; (2) ICSI cycles with maternal age <34 years. Male partners were stratified into age categories at 5-year intervals (31-35 years, 36-40 years, and 41-51 years) in these two designs. In the first design, most outcomes of assisted reproductive techniques were similar during the three groups, but the maternal age is much lower in the first group, and the mean number of retried oocytes and estradiol level on the day of human chorionic gonadotropin injection was significantly higher in the first group. In the second design, the outcome of intracytoplasmic sperm injection and clinical factors including the estradiol level on the day of human chorionic gonadotropin injection, the number of retrieved oocytes, the rate of cleaved oocytes, the number of transferred embryos, the numbers of transferred good embryos, the clinical pregnancy rate per transfer cycle and the implantation rate were similar among the three groups of women aged <34 years after adjusting for female age. There is insufficient evidence to demonstrate an unfavorable effect of advanced paternal age on the fertility outcome for TESE-ICSI. The thawed testicular spermatozoa from males aged ≤ 40 years did not have an adverse impact on ICSI outcomes.

Tsai YR ，Lan KC ，Kung FT ，Lin PY ，Chiang HJ ，Lin YJ ，Huang FJ ... -  《-》

Fresh motile testicular sperm retrieved from nonobstructive azoospermic patients has the same potential to achieve fertilization and pregnancy via ICSI as sperm retrieved from obstructive azoospermic patients.

Kanto S ，Sugawara J ，Masuda H ，Sasano H ，Arai Y ，Kyono K ... -  《-》

[Non-obstructive azoospermia: option of the testicular sperm extraction performed on the day of oocyte retrieval].

Analyzing the results and validating the procedure of testicular sperm extraction (TESE) performed on the day of oocyte retrieval in non obstructive azoospermia (NOA) patients. Sixty TESE were performed on the day of oocyte retrieval (dOR), in 52 NOA men. Patients were sorted into three groups according to the results of the surgical procedure: 1: sperm recovery with possible sperm freezing (n=20); 2: sperm recovery without freezing (n=27); 3: "negative" biopsy (n=13). ICSI outcomes in the two groups with sperm recovery were compared to those of ICSI performed with frozen-thawed sperm obtained from TESE performed (n=13). The rate of positive sperm retrieval was 78%. While the overall clinical pregnancy rate was 50%, no difference in the fertilization, implantation and clinical pregnancy rates was found in the two groups with positive sperm retrieval as compared to frozen-thawed sperm group. Twelve pregnancies were obtained in patients without further sperm cryopreservation. After TESE in NOA men, cryopreserved sperm produced comparable results with freshly obtained sperm. However, TESE performed on dOR can offer the opportunity, in patients with rare sperm that might not survive freeze-thaw, to have a possible fresh embryo transfer. Couples should be counselled regarding the possibility of oocyte retrieval without sperm for ICSI.

Grynberg M ，Chevalier N ，Mesner A ，Rocher L ，Prisant N ，Madoux S ，Feyereisen E ，Ferlicot S ，Fanchin R ，Frydman R ，Frydman N ，Izard V ... -  《-》

Fertilization and embryo development with spermatozoa obtained from testicular sperm extraction into oocytes generated from human chorionic gonadotropin-primed in vitro maturation cycles.

To evaluate the fertilization rate and embryo development resulting from intracytoplasmic sperm injection (ICSI) of spermatozoa retrieved by testicular sperm extraction (TESE) in hCG-primed in vitro maturation (IVM) cycles. Case-control study. University teaching hospital. Twenty-four IVM cycles were performed in 21 patients (mean age, 32.3 ± 2.4 years) with polycystic ovaries (PCO) whose partners were nonobstructive azoospermic. Twelve cycles where IVM oocytes were also retrieved were compared with a control group consisting of age-matched IVM cycles with ICSI using ejaculated spermatozoa (n = 12). In vitro maturation treatment with TESE sperm. Fertilization and embryo development between sibling oocytes matured in vivo and in vitro. Eight singleton pregnancies and one twin pregnancy were obtained after ET (9/24, 37.5%). In the 12 IVM cycles where in vivo-matured oocytes were also obtained, the fertilization rate after TESE-ICSI was significantly higher in in vivo-matured oocytes than in sibling in vitro-matured oocytes (84.2% vs. 53.2%). The proportion of good quality embryos was also higher (63.5% vs. 40.2%). In the control group of cycles with ejaculated spermatozoa, there was no difference in fertilization rates between sibling oocytes matured in vivo and in vitro (84.6% vs. 79.6%). Our results suggest that IVM of immature oocytes combined with TESE-ICSI is an option for couples with PCO and azoospermia. However, there are lower fertilization and good quality embryo rates achieved when TESE-ICSI was done with in vitro-matured oocytes. Additional studies are necessary to determine the role of this treatment combination.

Son WY ，Chung JT ，Henderson S ，Reinblatt S ，Buckett W ，Chan PT ，Holzer H ... -  《-》