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• W2976458527 abstract "Due to controversial evidence that testicular sperm is associated with lower sperm DNA fragmentation (SDF) and improved outcomes compared to ejaculated sperm (ES), this study evaluates intracytoplasmic sperm injection (ICSI) outcomes using testicular sperm in nonazoospermic couples with prior IVF failure using ES. Retrospective cohort Jan 2015-Aug 2018, 64 nonazoospermic couples with ≥1 prior failed ART cycles using ES underwent testicular sperm extraction (TESE) for IVF-ICSI. Failed cycles with ES: those not progressing to clinical pregnancy. Outcomes using TESE sperm were compared to the mean values of couples’ prior cycles using ES. Primary outcomes: clinical pregnancy and live birth rates (CPR & LBR). Secondary outcomes: fertilization and blastocyst conversion. Average number of prior failed ART cycles using ES: 2.5 (range: 1-8). 71.8% of males had abnormal semen parameters. A subset of men (n=28) had SDF assessment (measured by sperm chromatin dispersion) of ES. Mean SDF was 39% (7-84%); 21 patients had SDF >25%. 88 total ICSI cycles were performed using TESE sperm (64 cycles:fresh TESE, 24 cycles:frozen-thawed). There were 52 fresh blastocyst transfers, 15 frozen blastocyst transfers, and 21 cycles without transfer (9 additional FETs using supernumerary embryos; 76 total transfers). A comparison of TESE-ICSI cycles in those couples with ≥2 prior failed ART cycles using ES yielded similar findings to the whole group.Table 1Outcomes comparing TESE couples to their prior ART cycles using ES. Blastocyst conversion=% of cycles with ≥1 blastocysts available to use. P values comparing pregnancy outcomes were not performed due to regression of the mean.TESE (n=88), MeanEjaculated (n=64), MeanP valueEjaculated SDF >25%: TESE (n=21; 24 transfers), MeanEjaculated SDF >25%: Ejaculated (n=21), MeanP value# oocytes retrieved17.817.40.2719.516.30.27#M2's11.712.10.7211.610.80.74% M2's fertilized61.4%59.0%0.6657.1%50.6%0.37No blastulation24/88 (27.3%)39/64 (60.9%)<0.0019/21 (42.9%)15/21 (71.4%)0.02Blastocyst conversion61.9%42.9%<0.00157.1%28.6%0.001# blastocysts transferred1.71.60.561.71.50.56# blastocysts vitrified1.60.60.0031.20.40.006CPR32/76 (42.1%)0%---10/24 (41.7%)0%---Spontaneous abortion8/76 (10.5%)0%---1/24 (4.2%)0%---LBR27/76 (35.5%)0%---9/24 (37.5%)0%--- Open table in a new tab In nonazoospermic couples with failed ART using ES, ICSI using TESE sperm may improve blastocyst development, number of embryos available for vitrification, CPRs, and LBRs. Testicular sperm may avoid the adverse effects of elevated SDF from ES and improve pregnancy outcomes in some patients. Randomized studies are needed to determine if such a benefit exists." @default.
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• W2976458527 date "2019-09-01" @default.
• W2976458527 modified "2023-10-18" @default.
• W2976458527 title "Does use of testicular sperm improve outcomes in nonazoospermic couples with previous IVF failure using ejaculated sperm?" @default.
• W2976458527 doi "https://doi.org/10.1016/j.fertnstert.2019.07.649" @default.
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