Long‐term clinical outcomes of testicular sperm extraction and intracytoplasmic sperm injection for infertile men

Abstract

PurposeTo find the best methods to achieve the highest pregnancy and birth rates for couples needing testicular sperm extraction (TESE)‐intracytoplasmic sperm injection (ICSI).MethodsRetrospectively studied were 801 patients with male factor infertility who had undergone TESE‐ICSI between April, 1996 and July, 2016 and who had been categorized into four groups: obstructive azoospermia (OA); non‐obstructive azoospermia (NOA); Klinefelter syndrome (KS); and cryptozoospermia (Crypt). The sperm retrieval rate, hormone levels, fertilization rate (FR), pregnancy rate (PR), and birth rate (BR) after ICSI among three groups were compared: fresh testicular sperm (FS)‐fresh oocytes (FO) (Group I); frozen‐thawed testicular sperm‐FO (Group II); and FS‐vitrified‐warmed oocytes (Group III).ResultsThe testicular sperm recovery rate was 57.8% (463/801): 89.6% in the Crypt, 97.1% in the OA, 28.9% in the NOA, and 42.2% in the KS groups. The follicle‐stimulating hormone levels were significantly higher in the NOA and KS groups and the testosterone levels were significantly lower in the KS group. The FR, PR, and BR were: 65.2%, 43.2%, and 28.5% in group I; 59.2%, 33.4%, and 18.7% in group II; and 56.4%, 33.8%, and 22.1% in group III.ConclusionIntracytoplasmic sperm injection with FS‐FO achieved the best PR and BR. It should be considered what to do in cases with no testicular sperm by TESE. The authors hope that ICSI with donor sperm will be allowed in Japan in the near future.

Y chromosome microdeletion screening using a new molecular diagnostic method in 1030 Japanese males with infertility

“…Okuyama et al . 17 reported that the SRR of Japanese patients with NOA was 28.9%, which was similar to that observed in the present study. SRR was 0 for patients with AZFa, AZFb, and AZFb+c deletions in the present study; however, the number of patients analyzed was small.…”

At what age should we attempt to retrieve sperm from males with Klinefelter syndrome

“…In regards to the use of freshly retrieved sperm or the use of previously cryopreserved sperm from Klinefelter males, Vicdan et al feel that, in their reproductive program, "The use of fresh or cryopreserved-thawed spermatozoa on ICSI cycle outcomes are equally successful in patients with KS" (54). However, Okuyama and colleagues reported that the use of freshly harvested sperm and freshly retrieved oocytes had a significantly better pregnancy and birth rate than the use of frozen-thawed sperm and fresh oocytes, 43.2% and 28.5% compared to 33.4% and 18.7% (56). At this time, the philosophy employed by the reproductive clinicians and embryologists involved in these cases, vis-àvis fresh vs. frozen sperm, is program specific and variable.…”

Fresh vs frozen testicular sperm for assisted reproductive technology in patients with non-obstructive azoospermia: A systematic review

“…(Origio) then nitrogen vapour in a plastic freezing box (–1°C/min) Fresh testicular sperm from NOA cases (cryptozoospermic cases were also compared) 48 22 49.0 52.1 18.8 18.2 12.2 7.3 18.8 4.5 No difference in 2 PN%, CPR, LBR and IR between the two studied groups Okuyama et al . 2018 [ 35 ] Testicular sperm suspension, sperm freeze (Medi-con) then 15 min in LNV Fresh testicular sperm from NOA cases (Fresh oocytes) (OA cases and cryptozoospermic cases were also compared) 78 71 52.6 59.4 34.3 49.3 12.5 31.5 A difference in LBR in favour of the fresh sperm group Falah 2019 [ 36 ] Testicular sperm suspension, sperm freeze (FertiPro) then 15 min in LNV Fresh testicular sperm from NOA cases (OA cases were also compared) 36 32 36.0 37.0 14.3 20.0 3.6 4.0 No difference in 2 PN%, CPR and LBR between the two studied groups Zhang et al . 2021 [ 37 ] Testicular sperm suspension, sperm freezing med.…”