Pregnancies and births resulting from in vitro matured oocytes fertilized with testicular spermatozoa

Abstract

Purpose : In vitro maturation (IVM) of immature human oocytes is an attractive option for the treatment of infertility. Similarly, intracytoplasmic sperm injection (ICSI) followed by testicular fine needle aspiration (TEFNA) is an important treatment for primarily male-factor infertility. This report highlights the combination of these two advanced assisted reproduction techniques, namely IVM and fertilization with TEFNA-retrieved spermatozoa by ICSI to overcome both of male and female infertility problems. Methods : Before immature oocyte retrieval (IOR), gonadotropin stimulation was given for 3 or 5 days. Following IVM, and mature oocytes were inseminated by ICSI followed by TEFNA. Results : Four couples with five completed treatment cycles were performed, and total of 36 immature oocytes were retrieved. Following 36 to 48 h of culture, 32 (88.89%, 32/36) oocytes became mature. The mature oocytes were inseminated with TEFNA-retrieved sperm, and 18 (56.25%, 18/32) oocytes were fertilized normally following ICSI. Eleven embryos were transferred in five cycles and two pregnancies and two singleton births were achieved in two patients. Conclusions : This result demonstrates that the successful pregnancies and live births can be established from embryos produced from in vitro matured oocytes that fertilized with testicular sperm.KEY WORDS: ICSI; immature human oocytes; in vitro maturation; testicular fine needle sperm aspirations.

Delivery after Transfer of Frozen-thawed Embryos from In Vitro-Matured Oocytes in a Woman at Risk for Ovarian Hyperstimulation Syndrome

“…The technique of IVM of human oocytes is an attractive alternative to infertility, and successful pregnancies and newborn infants have been obtained after IVM of oocytes recovered from patients with PCOS [1,2] and in poor responders to stimulation during IVF cycles [8][9][10]. Recently, IVM was successfully introduced to treat high responders to ovarian stimulation, who are at risk of developing OHSS; OHSS results in higher cycle cancellation rates, lower pregnancy rates, or even death in rare cases.…”

Birth after human chorionic gonadotropin-primed oocyte in vitro maturation and fertilization with testicular sperm in a normo-ovulatory patient

“…The published experience of IVM using testicular sperm is quite heterogeneous, and in some reports, the stimulation is more intense than simple hCG priming,[ 5 6 10 ] contradicting the main benefit of IVM. On the other hand, apparently IVM in normo-ovulatory women and pregnancy rates are lower than in PCOS patients.…”

“…One potential application is the use of IVM as a less expensive alternative to stimulated IVF in case of severe male infertility. The experience of using IVM with non-ejaculated sperm is limited, case reports of pregnancies are published from sperm obtained by testicular biopsy,[ 4 ] testicular fine-needle aspiration,[ 5 6 ] percutaneous epididymal sperm extraction,[ 7 ] and microtesticular sperm extraction. [ 8 ] Nevertheless, some of the reports used a low stimulation including low doses of follicle-stimulating hormone (FSH), menotropins, or clomiphene citrate that constitute “mild stimulation” cycles and not IVM.…”