Sperm source does not affect the ICSI outcome of patients with severely compromised spermatogenesis

Abstract

Patients with spermatogenic dysfunction may display sperm parameters ranging from extremely severe oligozoospermia (sperm count lower than 2 million/ml) to azoospermia. It has been proposed that, since these patients may have increased sperm DNA damage that could affect their ICSI outcome, the use of surgically retrieved testicular spermatozoa should be preferred to improve their chance of fathering their biological offspring. However, studies in this field have yielded conflicting results. The present study provides an updated assessment of this subject by comparing the ICSI outcome of 762 patients with nonobstructive azoospermia and 419 with sperm count lower than 2 million/ml (median sperm count 300,000/ml). Both groups were homogeneous for the number of retrieved and injected MII oocytes. No difference was seen in terms of fertilisation, clinical pregnancy and cumulative live birth rates. Only the number of injected MII oocytes was found to independently predict the live birth rate, even when adjusted for the number of transferred embryos (OR 1.10 (1.0–1.2, p = 0.038)). The results of the present study stand against the use of testicular spermatozoa in patients with extremely severe spermatogenic dysfunction with available spermatozoa in their ejaculate.

Effects of different sperm sources on clinical outcomes in intracytoplasmic sperm injection cycles

“…In this study, embryonic cells were cultured in vitro until the 3rd or 5th day for transfer, and the number of transplanted embryos was roughly the same in all four groups. The study (Caroppo et al, 2020) compared the ICSI results of testicular sperm and ejaculated sperm patients without significant differences in clinical outcomes, which was consistent with our research results, and proposed to oppose the use of testicular sperm in patients with extremely severe spermatogenesis disorders who had available sperm in their semen. It (Morin et al, 2020) was also suggested that there was no difference in the live birth rate between testicular‐derived and epididymal‐derived blastocysts.…”

Application of single-cell RNA sequencing on human testicular samples: a comprehensive review

“…Spermatogenic dysfunction was characterized by the impairment of intratesticular spermatogenesis, and NOA is the most severe condition of it 103 . NOA was clinically diagnosed with no sperm in ejaculates along with evidence reflecting/causing the impairment of testicular spermatogenesis (e.g., elevated FSH or history of chemotherapy) 104 .…”

Testicular histopathology and associated factors in men with non-obstructive azoospermia

“…This result is similar in previous reports of the association between testicular volume and hormonal level with testicular histopathology. 6,18,19 who already For each unit increase in FSH concentration, the odd of a more severe histopathological pattern increased by 7.1% (95%CI: 1.01-1.12).…”