Audit Of Testicular Sperm In Assisted Reproduction For Non-Azoospermic Infertile Couples

You have accessJournal of UrologyInfertility: Therapy (MP31)1 Sep 2021MP31-01 AUDIT OF TESTICULAR SPERM IN ASSISTED REPRODUCTION FOR NON-AZOOSPERMIC INFERTILE COUPLES Christopher Merrett, Daniel Schlager, Apostolos Georgiannakis, Rabi Odia, Ephia Yasmin, Srividya Seshadri, Paul Serhal, David Ralph, and Philippa Sangster Christopher MerrettChristopher Merrett More articles by this author , Daniel SchlagerDaniel Schlager More articles by this author , Apostolos GeorgiannakisApostolos Georgiannakis More articles by this author , Rabi OdiaRabi Odia More articles by this author , Ephia YasminEphia Yasmin More articles by this author , Srividya SeshadriSrividya Seshadri More articles by this author , Paul SerhalPaul Serhal More articles by this author , David RalphDavid Ralph More articles by this author , and Philippa SangsterPhilippa Sangster More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002035.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is increased interest in using testicular sperm in assisted reproduction technology (ART) to improve outcomes after previous failed cycles. Mehta et al. (2015) reported results of a 50% live birth rate using testicular sperm in the first cycle for couples with oligospermia and a history of failed cycles with ejaculated sperm. The possible rationale is testicular sperm may be protected from DNA damage relative to ejaculated sperm and therefore may be superior for use in ART. We audited our rates of live births and fertilization in non-azoospermic infertile couples who underwent surgical testicular sperm retrieval despite having injectable sperm on their semen analysis. METHODS: We conducted a retrospective audit of surgical testicular sperm retrievals at one institution over a three-year period (2018-2020). We identified 31 couples with injectable sperm on their semen analysis and had previous failed cycle attempts using ejaculated sperm. RESULTS: Couples had an average male age of 40 (SD=6.0) and an average female age of 38 (SD=4.0). The men had an average serum testosterone of 15.5 nmol/L (SD=6.2 nmol/L) and an average serum FSH of 8.7 IU/L (SD=6.8 IU/L). 68% (n=21) of men had a DNA fragmentation index completed with an average score of 39% (SD=8.3%). In the women the mean serum anti-Müllerian hormone (AMH) was 11.8 pmol/l (SD=10.0 pmol/l). Prior to testicular sperm retrieval, using ejaculated sperm the fertilization rate was 55% (95% CI [46%, 64%]) and blastocyst conversion rate was 39% (95% CI [25%, 53%]). There was no statistical significance with testicular sperm where the fertilization rate was 57% (95% CI [51%, 63%]) and blastocyst conversion rate was 50% (95% CI [38%, 62%]). Overall, there were 7 clinical pregnancies in this population of couples. Of these clinical pregnancies, 2 miscarried and 5 progressed to a live birth. This audit yielded a live birth rate per cycle of 12% and a live birth rate per couple of 16%. CONCLUSIONS: In our cohort of couples with injectable sperm available in their semen, 16% had a live birth using testicular sperm after at least one previous failed cycle. Therefore, testicular sperm did not yield a higher live birth rate outcome compared with national average ART rates. We recommend caution and further analysis going forward using testicular sperm. Source of Funding: Self-funded © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e555-e555 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Merrett More articles by this author Daniel Schlager More articles by this author Apostolos Georgiannakis More articles by this author Rabi Odia More articles by this author Ephia Yasmin More articles by this author Srividya Seshadri More articles by this author Paul Serhal More articles by this author David Ralph More articles by this author Philippa Sangster More articles by this author Expand All Advertisement Loading ...