Intracytoplasmic Spermatid Injection Can Result in the Delivery of Normal Offspring

Abstract

Almost one-third of all patients with nonobstructive azoospermia undergoing testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) have cancelled cycles due to failure to find spermatozoa. For these patients, every attempt should be made to rescue the cycles by searching for spermatids. In this retrospective study, we report our experience in using elongating (stage Sb2) and elongated (stage Sc and Sd1) spermatids for ICSI. The study included 488 consecutive ICSI and TESE cycles performed for 452 patients with nonobstructive azoospermia. In 179 (36.7%) cycles, neither spermatozoa nor mature spermatids (stage Sd2) suitable for injection were found. After an extensive search only Sb2, Sc, and Sd1 spermatids were found in 22 of these 179 cycles (12.3%). These spermatids were used for injection of retrieved oocytes. The fertilization rate was 33.2%, and 19 patients (86.4%) reached the embryo transfer stage. In 6 cycles a chemical pregnancy occurred, and 3 clinical pregnancies were established, resulting in the delivery of 3 healthy boys with normal karyotypes. When normal living spermatozoa or mature spermatids (stage Sd2) cannot be found during TESE, late spermatids (stage Sb2, Sc, and Sd1) can be used successfully and result in the delivery of healthy offspring.

Reproductive medicine and inheritance of infertility by offspring: the role of fetal programming

“…The offspring born after spermatid intracytoplasmic injection have been reported to be normal (78). This is consistent with those studies that found that methylation patterns in relation to imprinted alleles are already defined at the spermatogonia stage (79,80).…”

The Effect of Piezoelectric Stimulation in Patients with Low Fertilization Potential

“…In the beginning we decided to evaluate elongated spermatid injected oocytes and observed a fertilization rate of 27.9% whereas various studies have reported 24% [48,49] and 71% [50]. Although we had piezoelectrically stimulated the oocytes of patients with elongated spermatids; our data is still similar to non-activated studies.…”

Azoospermia: is sample centrifugation indicated? A national survey of practice and the Oxford experience

“…The presence of spermatids is possibly more likely in men with azoospermia, and, although there have been successful outcomes (9,10), the use of spermatids in ICSI-IVF treatment should still be considered experimental (11,12).…”