Development of a new and efficient laboratory method for processing testicular sperm.

Abstract

Purpose : Testicular biopsy specimens contain large amounts of debris that makes sperm pickup for ICSI more difficult than with epididymal aspirates. We sought to develop improved processing techniques for testicular sperm extraction (TESE). Methods : Retrievals were with azoospermic male partner scheduled to undergo percutaneous epididymal sperm aspiration (PESA) and TESE. The study group consisted of 9 retrievals with a new TESE technique (TESE-N). The control group was 21 retrievals with PESA and 3 retrievals with a previous TESE technique (TESE-P). Results : TESE-N eliminated almost all debris, which made ICSI sperm pick-up more rapid. TESE-N, PESA, and TESE-P fertilization (77, 75, and 72%) and ongoing/delivered pregnancy rates per retrieval (67, 76, and 67%) were similar. Conclusions : Our new technique provides for easy removal of debris from TESE specimens and fertilization and pregnancy rates equal to epididymal sperm's. Eliminating debris from TESE specimens allows for rapid sperm pick-up for ICSI, making the procedure more efficient for embryology staff.

Technical modification of testicular sperm extraction expedites testicular sperm retrieval

“…Enzymatic preparation was alleged to expedite sperm pick-up, eliminating tissue debris (9). The enzymes collagenase type IA or IV and elastase were used to dissociate the testicular tissue (8).…”

A new method to process testicular sperm: combining enzymatic digestion, accumulation of spermatozoa, and stimulation of motility

“…The reason for this difference is unclear, but may be due to greater difficulties in isolating a clean preparation of motile testicular sperm due to the presence of many different cell types in testicular tissue [17]. In azoospermic patients, besides mechanical mincing, vital spermatozoa can be obtained from testicular tissue by enzymatic digestion [16,18].…”

A laboratory modification to a testicular sperm preparation technique improves spermatogenic cell yield

“…This observation was documented by one group where assisted reproduction outcomes in TESE cases were compared with percutaneous epididymal sperm aspiration results. Hammitt et al 36 eliminated debris by density gradient centrifugation after TESE and had similar ongoing pregnancy and delivery rates to those from centrifuging only in SWM. On the other hand, sperm retrieval was easier when density gradient centrifugation was used.…”