Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies

Abstract

Background Azoospermic patients have benefited from both epididymal and testicular spermatozoa intracytoplasmic sperm injection (ICSI) treatment and lasers have been used to identify viable, immotile spermatozoa before the procedure. There are limited studies on the safety of laser-assisted selection of immotile spermatozoa. The aim of this study was to investigate the impact of laser-assisted selection of immotile spermatozoa on the obstetric and neonatal outcomes after ICSI. Methods A retrospective comparative study was conducted on outcomes of ICSI cycles with testicular spermatozoa from June 2014 to June 2018. Of 132 cycles, 33 were allocated to the test group and oocytes were injected with immotile spermatozoa selected by laser, 99 cycles were allocated as control group. Results Compared with the control group, no significant differences were found in the pregnancy, implantation, miscarriage and live birth rates in the test group in either fresh or frozen transfer cycles. The cumulative live birth rate in the test group was 69.70%, which was slightly higher than in the control group (60.61%), but this was not statistically different. There were no differences in the average gestational age, premature birth rate, neonatal birth weight, and the malformation rate between the test and control groups (P > 0.05). In addition, the obstetric outcome between the two groups were not different (P > 0.05). Conclusions No negative effect on perinatal and neonatal outcomes was seen by using laser-assisted selection of immotile spermatozoa for TESA-ICSI. This study endorses the use of laser-assisted selection of viable spermatozoa for ICSI cycles.

Applications of laser technology in the manipulation of human spermatozoa

“…Those sperm that presented with curling of the tails were regarded as viable. • Time-saving • Easy to perform • Noncontact • Can be performed during ICSI • Need for laser equipment • Still not standardized [ 79 , 80 , 83 , 84 , 86 – 89 ] WHO: World Health Organization; ICSI: intracytoplasmic sperm injection …”

“…This study confirmed that combined with laser-assisted selection of viable sperm, completely immotile sperm can be frozen for fertility preservation [ 88 ]. Recently, a retrospective comparative study by Chen et al demonstrated that no negative effect on perinatal and neonatal outcomes was observed in patients with immotile sperm by using laser-assisted selection for ICSI [ 89 ].…”

“…Both energy levels of the laser pulse are slightly different. A single shot of 120–400 µJ is sufficient to detect viable but immotile sperm [ 80 , 83 , 87 – 89 ]. For the immobilization of sperm using a double shot strategy, due to splitting up energy into two separate pulses, the total energy applied to the sperm should be higher compared to the selection of immotile sperm.…”

Laser-Guided Sperm Selection: Optimizing the Reproductive Success Rate in Assisted Reproductive Technology

“…Fertilization can still occur with immotile sperm, indicating that sperm viability is more important for successful fertilization. Consequently, the issue of selecting a live sperm from a pool of immotile sperm on the day of oocyte retrieval for ICSI is of paramount importance [ 2 ]. Injection of immotile spermatozoa from ejaculates or biopsies has resulted in pregnancies and healthy offspring [ 3 ].…”