The Efficacy of Repeat Percutaneous Epididymal Sperm Aspiration Procedures

Pasqualotto, Fábio Firmbach; Rossi-Ferragut, Lia Mara; Rocha, C.C.; Iaconelli, Assumpto; Ortiz, Valdemar; Borges, Edson

doi:10.1097/01.ju.0000066849.32466.2b

Cited by 19 publications

(12 citation statements)

References 19 publications

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“…It has been suggested that the subsequent scarring could impair the efficacy of repeat procedures that are invariably necessary as the chances of sufficient sperm being retrieved for cryopreservation with such aspiration procedures are low. This is confirmed in a recent study that reported motile sperm for ICSI in only 26% of repeat PESA procedures 24 …”

Section: Sperm Retrieval Techniquessupporting

confidence: 79%

REVIEW: Assisted reproduction in the azoospermic couple

Nicopoullos

Ramsay

Almeida

et al. 2004

BJOG

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Section: Sperm Retrieval Techniquessupporting

confidence: 79%

REVIEW: Assisted reproduction in the azoospermic couple

Nicopoullos

Ramsay

Almeida

et al. 2004

BJOG

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“…Optional treatment of these cases is usually using testicular sperm extract (TESE) or donor sperm. The fact is that the parameter of TESE in the oligozoospermia patients without obstructive factor is obviously worse than the ejaculate semen, and immature TESE gametes may cause lower reproductive ability [ 19 , 20 ] and the risks of potential imprinting defects [ 21 – 23 ]. Utilization of own gametes instead of donors to become a biological parent is always an aspiration for the couple.…”

Section: Introductionmentioning

confidence: 99%

Decreased Sperm Motility Retarded ICSI Fertilization Rate in Severe Oligozoospermia but Good-Quality Embryo Transfer Had Achieved the Prospective Clinical Outcomes

Zheng

et al. 2016

PLoS ONE

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IntroductionSpermatozoa motility is the critical parameter to affect the treatment outcomes during assisted reproductive technologies (ART), but its reproductive capability remains a little informed in condition of severe male factor infertility. This retrospective cohort study aimed to evaluate the effects of reduced sperm motility on the embryological and clinical outcomes in intra-cytoplasmic sperm injection (ICSI) treatment of severe oligozoospermia.Patients and Methods966 cycles (812 couples) of severe oligozoospermia diagnosed by spermatozoa count ≤ 5 × 106/mL and motile spermatozoa ≤ 2 × 106/mL were divided into four groups in according to the number of motile spermatozoa in one ejaculate on the day of oocyte retrieval (Group B—E). The control (Group A) was 188 cycles of moderate oligozoospermia with spermatozoa count > 5 × 106/mL and motile spermatozoa > 2 × 106/mL. All female partners were younger than 35 years of age. Logistic regression analyzed embryological outcomes (the rates of fertilization, cleavage and good-quality embryo) and clinical outcomes (the rates of pregnancy, implantation, early miscarriage and live birth). Quality of embryo transfer (ET) was divided into three classes as continuous factor to test the effects of embryo quality on clinical outcomes.ResultsThe reduction in the number of motile sperm in four groups of severe oligozoospermia gave rise to comparable inability of the fertilization (p < 0.001) and a decreased rate of good-quality embryo at Day 3 (p < 0.001) by compared to the control. The cleavage rate of the derived zygotes was similar to the control. ET classes significantly affected the clinical outcomes (p < 0.001). Class I ET gave rise to similar rates of clinical outcomes between five groups, but Class II and Class III ET retarded the rates of pregnancy, implantation and live birth and this particularly occurred in Group C, D and E. The rate of early miscarriage was not comparably different between groups. Overall rates in all groups were 41.26% clinical pregnancy, 25.74% implantation and 36.32% live birth, which gave live birth to 252 girls and 252 boys.ConclusionsThe reduction of motile spermatozoa in severe oligozoospermia decreased the rates of fertilization and good-quality embryo. Obtaining and transfer of good-quality embryos was the good prognostic to achieve prospective clinical outcomes regardless of the severity of oligozoospermia.

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“…Research conducted during the last decade has provided growing support to the concept that oxidative stress (OS) is one of the main causes of male infertility. Oxidative stress occurs either as a result of increased levels of reactive oxygen species or insufficient antioxidant capacity (6,7).…”

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confidence: 99%