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Abstract

This study shows that the outcome of fresh and frozen-thawed testicular spermatozoa in ICSI is comparable, obstructive and nonobstructive etiologies perform the same, and that preincubation of testicular spermatozoa results in increased fertilization and pregnancy rates. All testicular biopsies are therefore performed the day before oocyte retrieval, superfluous spermatozoa cryopreserved, and the remaining testicular homogenate preincubated for the 24 h prior to oocyte retrieval. With this regime, most azoospermic patients are treated successfully, irrespective of the use of fresh or frozen-thawed spermatozoa from obstructive or nonobstructive cases.

Effect of in vitro testicular spermatozoa culture on pregnancy outcomes: an experience at a single university hospital

“…Among these factors, the motility of spermatozoa is emphasized as an important predictive factor for successful fertilization by ICSI [15]. In vitro maturation of spermatozoa has been suggested as a way to improve sperm motility, thereby improving pregnancy outcomes in TESE-ICSI cycles [16][17][18][19]. In a study by Balaban et al [20], the fertilization rate increased from 42.1% to 68.8% after in vitro culture of spermatozoa with improved sperm motility.…”

Impact on ICSI outcomes of adding 24 h of in vitro culture before testicular sperm freezing: a retrospective study

“…Although fertilization and pregnancy rates were similar [ 32 ], implantation rates were lower [ 1 ] and spontaneous abortion rates were higher [ 33 ] in ICSI cycles with frozen testicular spermatozoa than with fresh spermatozoa. Moreover, even though several authors have reported that extended in vitro culture improved the motility of testicular spermatozoa, very few studies have analyzed implantation, pregnancy and delivery rates following this treatment process [ 18 , 23 , 24 , 34 ] (Table 3 ). Only one reported a significant improvement in the fertilization rate with the use of spermatozoa incubated for 24 h [ 18 ].…”

“…Moreover, even though several authors have reported that extended in vitro culture improved the motility of testicular spermatozoa, very few studies have analyzed implantation, pregnancy and delivery rates following this treatment process [ 18 , 23 , 24 , 34 ] (Table 3 ). Only one reported a significant improvement in the fertilization rate with the use of spermatozoa incubated for 24 h [ 18 ]. However, in this study with unfrozen cultured spermatozoa, the clinical pregnancy rate was very low as compared to the biochemical pregnancy rate (35.3 % vs 53.9 %, respectively), suggesting a high number of miscarriages with spermatozoa processed in this way, which agrees with our findings.…”

Availability, effectiveness and safety of ART in sub-Saharan Africa: a systematic review

“…No. cycles not specified.xWindt et al (2002)Retrospective Cohort (M)Not specified142 aspiration cycles with ≥ one oocytes; fertilisation by ICSI with testicular extracted spermxET, embryo transfer; GIFT, gamete intrafallopian transfer; GOC, gynaecology outpatient clinic; H, high quality; low quality; M, medium quality; No., number. a Not adherent to PRISMA guidelines. b Temporary infertility clinic in a research setting.…”

“…Mean annual CPR/ET ± 31%.Raja and Franken (2006)Prospective evaluation of sperm morphometrics and paternal sex chromosomes on ICSI outcome.Sperm selection using morphometrics associated with good fertilsation and PRs. Of 16 randomly selected embryos with no development 68.7% were XY.Windt et al (2002)Retrospective evaulation of use of fresh, cryopreserved and/or pre-incubated sperm on fertilisation and PRs after ICSI/TESE.Similar fertilisation and PRs in couples with obstructive vs non-obstructive azoospermia. Preincubated sperm for associated with similar ongoing PRs vs non-preincubation.Asp, aspiration; CRP, clinical pregnancy rate; DET, double embryo transfer; FET, frozen embryo transfer; MPR, multiple pregnancy rate; No., number; OD, oocyte donation; OHSS, ovarian hyperstimualtion syndrome; PCOS, polycystic ovary syndrome; PR, pregnancy rate; SET, single embryo transfer; TESE, testicular sperm extraction; USD, United States Dollar; WHO, world health organization. a Not adherent to PRISMA guidelines. b Not presented as part of original study results but calculated from original study data for purpose of this review. c Clinical pregnancy defined as intrauterine pregnancy with foetal heart. d Temporary infertility clinic in a research setting.…”