Fresh testicular sperm retrieved from men with spinal cord injury retains equal fecundity to that from men with obstructive azoospermia via intracytoplasmic sperm injection.
OBJECTIVE
To examine the outcomes of intracytoplasmic sperm injection (ICSI) with testicular sperm retrieved from men with spinal cord injury.


METHODS
Retrospective study.


METHODS
Private hospital-based infertility research laboratory.


METHODS
Twenty-two couples of whom one partner was a man with spinal cord injury (SCI).


METHODS
Reviewing the outcomes of testicular sperm extraction (TESE)-ICSI.


METHODS
Testicular sperm retrieval rate, fertilization rate, pregnancy rate, comparison with patients with obstructive azoospermia.


RESULTS
Testicular sperm were retrieved from 19 of 22 (86%) patients with SCI. Intracytoplasmic sperm injection resulted in a fertilization rate of 236 of 364 (65%). Of 19 couples, 14 couples achieved 18 pregnancies, and 22 infants (14 singleton and 4 twin) were born. (Pregnancy per couple was 74% and that per ICSI was 54%). There was no significant difference in pregnancy rate at the first ICSI between SCI couples and obstructive azoospermia couples (68% SCI, 68% obstructive azoospermia). However, pregnancy rate per fresh testicular sperm-ICSI was significantly higher than that per frozen-thawed sperm-ICSI in SCI couples (64% SCI fresh, 25% SCI frozen-thawed) although no significant difference was seen in obstructive azoospermia couples (76% obstructive azoospermia fresh, 63% obstructive azoospermia frozen-thawed). There was no significant difference in pregnancy rate between fresh ET cycle and frozen-thawed ET cycle in SCI couples.


CONCLUSIONS
Testicular sperm in men with SCI may possess disadvantages in freezing and thawing compared with that in men with obstructive azoospermia. Fresh testicular sperm-ICSI may offer optimum outcome for SCI couples desirous of pregnancy.
Kanto
Satoru
S
Kyono Art Clinic and Reproduction Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: skanto@ivf-kyono.or.jp.
Uto
Hirofumi
H
Kyono Art Clinic and Reproduction Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan.
Toya
Mayumi
M
Kyono Art Clinic and Reproduction Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan.
Ohnuma
Tetsutaro
T
Department of Urology, Tohoku Rosai Hospital, Tohoku University Graduate School of Medicine, Sendai, Japan.
Arai
Yoichi
Y
Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kyono
Koichi
K
Kyono Art Clinic and Reproduction Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan.
D000328:Adult; D053713:Azoospermia / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055101:Semen Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D053625:Sperm Retrieval; D013091:Spermatogenesis / Q000502:physiology; D013094:Spermatozoa / Q000473:pathology / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D055815:Young Adult