Influencia de la procedencia de los espermatozoides (testículo o eyaculado) en ciclos de ICSI de parejas estériles por factor masculino severo

Background

It is estimated that around a 3% of the couples are affected by severe male factor infertility -oligozoospermia, cryptozoospermia and non-obstructive azoospermia-. It is suggested the existence of postesticular sperm damage due to the oxidative stress that sperm suffers through the male genital tract. Base on this, different authors have propose the generalised use of testicular sperm, surgically retrieved (TESE), instead of ejaculated sperm.

Objectives

Analysing the influence of the sperm source in couples affected by severe male factor infertility in the ICSI results, when DNA ejaculated sperm fragmentation has not been tested before.

Material and methods

A retrospective study was conducted based on a specific severe male factor ICSI cycle database, according to the selected sperm source -testicle or ejaculate-.

Results

We analysed a total amount of 152 ICSI cycles which were divided into two groups, 107 cycles conducted with fresh ejaculated spermatozoa and 45 cycles conducted with criopreserved testicular biopsy spermatozoa. The results showed no significant differences in social-demographical or ovarian stimulation variables. ICSI cycles results were not different either; we obtained similar fertilization rates (54.3% vs. 48.6%), implantation rates (23.1% vs. 22.8%) and pregnancy per embryo transfer rates (35.5% vs. 37.1%). We observed a trend towards greater miscarriage rate between the testicular sperm cycles (18.5% vs. 46.1%), as well as a reduced live birth rate (28.9% vs. 20.0%) in this group. However, no significance differences were found after the analyses.

Conclusion

No evidences were found in favour of mass testicular spermatozoa vs. ejaculated spermatozoa use in ICSI cycles, when DNA ejaculated sperm fragmentation has not been tested before.