title: Blastocyst transfer following intracytoplasmic injection of ejaculated, epididymal or testicular spermatozoa.
abstract: Recent studies indicate a strong paternal influence on embryo development and progression of the embryo to the blastocyst stage. The aim of this study was to compare, during extended culture, the in-vitro development of embryos resulting from intracytoplasmic sperm injection (ICSI) of ejaculated spermatozoa (group 1, n = 347), epididymal (group 2, n = 22) or testicular (group 3, n = 18) spermatozoa from obstructive azoospermic and testicular spermatozoa from non-obstructive azoospermic (group 4, n = 31) subjects. Fertilization and blastocyst formation rates were significantly lower in group 4 (P < 0.05). The incidence of expanded and hatching blastocysts was significantly lower in group 4 (P < 0.05). Overall in 93.2% ejaculate ICSI cycles, blastocysts were transferred on day 5. This was significantly higher than the 62% day 5 transfers in the non-obstructive azoospermic group (P < 0.05). Implantation rate per embryo was significantly higher in the ejaculate ICSI group compared with the other groups (P < 0.05). Clinical pregnancy per transfer was similar between groups; however, significantly fewer multiple pregnancies were encountered in the non-obstructive azoospermic group (P < 0.01). In conclusion, the source of the spermatozoa, most likely to be indicative of the severity of spermatogenic disorder, affects the rate of blastocyst formation and blastocyst implantation. Spermatozoa from non-obstructive azoospermic subjects, when utilized for ICSI, result in embryos that progress to the blastocyst stage at a lower and slower rate and implant less efficiently.
authors.affiliation: Assisted Reproduction Unit, American Hospital of Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Balaban
authors.forename: B
authors.initials: B
authors.lastname: Urman
authors.forename: A
authors.initials: A
authors.lastname: Isiklar
authors.forename: C
authors.initials: C
authors.lastname: Alatas
authors.forename: R
authors.initials: R
authors.lastname: Mercan
authors.forename: S
authors.initials: S
authors.lastname: Aksoy
authors.forename: A
authors.initials: A
authors.lastname: Nuhoglu
mesh_terms: D000328:Adult; D004542:Ejaculation; D004624:Embryo Transfer; D005314:Embryonic and Fetal Development; D004822:Epididymis / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000473:pathology* / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013094:Spermatozoa / Q000473:pathology*; D013737:Testis / Q000473:pathology