Effect of testicular spermatozoa on embryo quality and pregnancy in patients with non-obstructive azoospermia

Abstract

This study was performed to assess and compare the outcomes of testicular sperm extraction (TESE)-intracytoplasmic sperm injection (ICSI) using spermatozoa from fresh and frozen testicular tissue from men with subgroups of non-obstructive azoospermia (NOA). A total of 110 cycles of TESE-ICSI were performed. Patients were classified into one of the following NOA subgroups: hypospermatogenesis (HS), maturation arrest (MA), or Sertoli cell-only syndrome (SCO). Laboratory (fertilization, cleavage stage of embryo, and good quality embryo) and clinical (pregnancy, clinical pregnancy, implantation, and delivery) outcomes were assessed. No statistically significant differences were observed in any of the other measured parameters between the three subgroups of NOA. No significant differences in laboratory outcomes were observed between spermatozoa from fresh and frozen testicular spermatozoa; however, statistically significant differences were observed in the pregnancy and implantation rates between groups (p50.05). The outcomes of using spermatozoa retrieved from fresh testicular tissue in each of the three subgroups were also compared; although clinical outcomes showed low results, no significant differences were observed between the three subgroups. Similarly, no significant differences were observed in spermatozoa retrieved from frozen testicular tissue. Once spermatozoa have been successfully obtained, acceptable laboratory outcomes can be achieved for NOA, whether or not the spermatozoa are cryopreserved. However, satisfactory clinical outcomes may be more difficult to achieve as the results showed in each group of fresh and frozen testicular spermatozoa. Therefore, achieving acceptable clinical pregnancy results and efficient cryopreservation of testicular spermatozoa should be considered in patients with NOA.

Paternal age as an independent factor does not affect embryo quality and pregnancy outcomes of testicular sperm extraction-intracytoplasmic sperm injection in azoospermia

“…Testicular sperm extraction (TESE) and the sperm preparation procedure were performed as described previously (Park et al., , ). Briefly, excised testicular tissue was rinsed two to three times with Quinn's Sperm Washing Medium (SAGE, Pasadena, CA, USA), squeezed with fine forceps under a dissecting microscope (×40–60) and analysed for the presence of spermatozoa (×200–400).…”

Effects of maternal age on embryo quality and pregnancy outcomes using testicular sperm with intracytoplasmic sperm injection

“…The rates of matured oocytes, fertilization, cultured high-quality embryos, transferred high-quality embryos, implantation, clinical pregnancy, and delivery were compared by maternal age between the obstructive azoospermia (OA, n=301 cycles) and non-obstructive azoospermia (NOA, n=115 cycles) groups. Male patients were evaluated, and azoospermia was classified as described previously [219]. Institutional review board approval was obtained for this study.…”

“…The TESE and sperm preparation procedures have been described in detail elsewhere [1220]. Briefly, testicular tissue was excised and rinsed with Quinn's Sperm Washing medium (SAGE, CooperSurgical, Trumbull, CT, USA).…”

“…Embryo cleavage of the two-pronuclear oocytes was evaluated after 48 additional hours of in vitro culture (day 3). Embryos were assessed according to a previously described embryo grading system [122122]. Embryos were graded according to the following criteria: grade I embryos, even blastomeres and no fragmentation; grade I-1 embryos, even blastomeres and <25% fragmentation; grade II embryos, uneven blastomeres and <25% fragmentation; grade II-1 embryos, uneven blastomeres and 25% to 50% fragmentation; and grade III embryos, even or uneven blastomeres and ≥50% fragmentation.…”

“…Moreover, satisfactory fertilization and pregnancy rates have been achieved by testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) [12]. The outcome of TESE-ICSI can be influenced by various factors, including the etiology of azoospermia and the source of the retrieved sperm, in addition to female-related factors such as age and ovarian reserve [3].…”