Re: Comparison of Reproductive Outcome in Oligozoospermic Men with High Sperm DNA Fragmentation Undergoing Intracytoplasmic Sperm Injection with Ejaculated and Testicular Sperm.
نویسنده
چکیده
OBJECTIVE To investigate the effectiveness of intracytoplasmic sperm injection (ICSI) using testicular sperm as a strategy to overcome infertility in men with high sperm DNA fragmentation (SDF). DESIGN Prospective, observational, cohort study. SETTING Private IVF centers. PATIENT(S) A total of 147 couples undergoing IVF-ICSI and day 3 fresh ETs whose male partner has oligozoospermia and high SDF. INTERVENTION(S) Sperm injections were carried out with ejaculated sperm (EJA-ICSI) or testicular sperm (TESTI-ICSI) retrieved by either testicular sperm extraction (TESE) or testicular sperm aspiration (TESA). SDF levels were reassessed on the day of oocyte retrieval in both ejaculated and testicular specimens. MAIN OUTCOME MEASURE(S) Percentage of testicular and ejaculated spermatozoa containing fragmented DNA (%DFI) and clinical pregnancy, miscarriage, and live-birth rates. RESULT(S) The %DFI in testicular sperm was 8.3%, compared with 40.7% in ejaculated sperm. For the TESTI-ICSI group versus the EJA-ICSI group, respectively, the clinical pregnancy rate was 51.9% and 40.2%, the miscarriage rate was 10.0% and 34.3%, and the live-birth rate was 46.7% and 26.4%. CONCLUSION(S) ICSI outcomes were significantly better in the group of men who had testicular sperm used for ICSI compared with those with ejaculated sperm. SDF was significantly lower in testicular specimens compared with ejaculated counterparts. Our results suggest that TESTI-ICSI is an effective option to overcome infertility when applied to selected men with oligozoospermia and high ejaculated SDF levels.
منابع مشابه
An algorithm to predict pregnancy in assisted reproduction.
BACKGROUND Male fertility potential cannot be measured by conventional parameters for the assisted reproduction technique; ICSI. This study determines the relationship between testicular and ejaculated sperm mitochondrial (mt) DNA deletions, nuclear (n) DNA fragmentation, and fertilization and pregnancy rates in ICSI. METHODS Ejaculated sperm were obtained from 77 men and testicular sperm fro...
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tau.amegroups.com © Translational Andrology and Urology. All rights reserved. We read with interest the commentary by Dr. Paul Turek (1) contextualizing the use of sperm DNA fragmentation (SDF) testing for male infertility in response to the recently published practice recommendations for SDF testing based on clinical scenarios by Agarwal et al. (2). We certainly concur with the author regardin...
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Background: With introduction of intracytoplasmic sperm injection with testicular sperm extraction or precutaneouse epididymal sperm aspiration, effective treatment was provided for azoospermic men. The aim of present study was to compare clinical outcome following intracytoplasmic sperm injection using extracted testicular/epididymal sperm or ejaculated severe oligoasthenoteratozoospermic sper...
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tau.amegroups.com © Translational Andrology and Urology. All rights reserved. Dr. Ahmad, in his well-written commentary (1), shared his viewpoints about the utility of sperm DNA fragmentation (SDF) testing on each clinical scenario proposed in the practice recommendations by Agarwal et al. (2). He highlighted the pitfalls of relying on quantitative semen parameters in current practice and the n...
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Background: CAPZA3 is one of the actin-capping proteins believed to be play an important role in controlling of actin polymerization during spermiogenesis and has been shown to be peresent in mature sperm. Immunohistochemistry showed that human CAPZA3 is localized in the neck region of ejaculated sperm, with moderate and faint signals also detected in the tail and post-acrosome region respectiv...
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ورودعنوان ژورنال:
- The Journal of urology
دوره 196 3 شماره
صفحات -
تاریخ انتشار 2015