USE OF TESTICULAR SPERM IN COUPLES WITH HIGH SPERM DEOXYRIBONUCLEIC ACID FRAGMENTATION AND FAILED INTRACYTOPLASMIC SPERM INJECTION USING EJACULATED SPERM

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2018PD01-02 USE OF TESTICULAR SPERM IN COUPLES WITH HIGH SPERM DEOXYRIBONUCLEIC ACID FRAGMENTATION AND FAILED INTRACYTOPLASMIC SPERM INJECTION USING EJACULATED SPERM Mohannad Alharbi, Fadl Hamouche, Simon Phillips, Jacques I. Kadoch, and Armand Zini Mohannad AlharbiMohannad Alharbi More articles by this author , Fadl HamoucheFadl Hamouche More articles by this author , Simon PhillipsSimon Phillips More articles by this author , Jacques I. KadochJacques I. Kadoch More articles by this author , and Armand ZiniArmand Zini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.215AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sperm deoxyribonucleic acid (DNA) fragmentation has been associated with male infertility and studies suggest that sperm DNA fragmentation can have an adverse influence on pregnancy outcomes with assisted reproduction. The aim of the present study was to examine the intracytoplasmic sperm injection (ICSI) pregnancy outcomes using testicular sperm in couples that have failed ICSI cycles using ejaculate sperm. METHODS We conducted a retrospective review of consecutive couples with sperm DNA fragmentation (>30% fragmentation by TUNEL- terminal deoxynucleotidyl transferase dUTP nick end labeling assay) that underwent ICSI using testicular sperm between December 2012 and July 2017. As a control group, we evaluated consecutive couples that had failed a first ICSI cycle and underwent a second ICSI cycle using ejaculated sperm. We excluded couples with female factors and advanced female age. RESULTS We identified 54 couples that underwent testicular sperm - ICSI (T-ICSI). Our control group consisted of 54 couples that underwent a second ICSI cycle using ejaculate sperm (Ej-ICSI) after a first ICSI cycle failure. Mean male and female age, as well as, the proportion of couples with primary infertility were not significantly different between the two groups (P>0.05). Mean fertilization rate was significantly lower in the T-ICSI compared to the Ej-ICSI group (44% vs. 58%, respectively, P=0.015). The mean number of oocytes collected in the T-ICSI compared to the Ej-ICSI group were significantly different (14 vs. 11, respectively, P<0.05). The mean number of embryos transferred in the T-ICSI compared to the Ej-ICSI group were not significantly different (1.65 vs. 1.5, respectively, P>0.05). Cumulative clinical pregnancy and live birth rates per transfer were higher in the T-ICSI than the Ej-ICSI group but the differences were not statistically significant (61% vs. 52% and 40% vs. 33%, respectively, P>0.05). CONCLUSIONS Our results indicate that testicular sperm - ICSI outcomes are not significantly better than ejaculated sperm-ICSI in couples with high sperm DNA fragmentation. Additional prospective and randomized trials are needed to determine the value of using testicular sperm for ICSI in couples with sperm DNA damage. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e60 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Mohannad Alharbi More articles by this author Fadl Hamouche More articles by this author Simon Phillips More articles by this author Jacques I. Kadoch More articles by this author Armand Zini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...