title: Pharmacological stimulation of sperm motility in frozen and thawed testicular sperm using the dimethylxanthine theophylline.
abstract: OBJECTIVE
  To evaluate whether the use of theophylline improves sperm motility and treatment outcome in frozen-thawed testicular sperm extraction (TESE).
  
  
  METHODS
  Artificial sperm activation was offered to azoospermic patients between January and October 2010 in two different centers (identical lab conditions).
  
  
  METHODS
  IVF units of public hospitals.
  
  
  METHODS
  Sixty-five patients participated and gave informed consent.
  
  
  METHODS
  Sibling oocytes were split into a study (intracytoplasmic sperm injection [ICSI] with thawed testicular sperm treated with theophylline) and a control group (ICSI with thawed untreated sperm).
  
  
  METHODS
  Sperm motility, time for sperm selection, rates of fertilization, implantation, clinical pregnancy, and live birth.
  
  
  RESULTS
  All patients but one (98.5%) showed a significant improvement in testicular sperm motility when theophylline was used. In addition, sperm selection took significantly less time in the study as compared with in the untreated control group. Corresponding rates of fertilization (79.9% vs. 63.3%) and blastulation (63.9% vs. 46.8%) were significantly increased. Significantly more patients achieved clinical pregnancy if embryos/blastocysts derived from oocytes that had been injected with pharmacologically stimulated testicular spermatozoa were transferred (53.9% vs. 23.8%). This also holds true for the implantation rate.
  
  
  CONCLUSIONS
  Theophylline turned out to be a reliable tool in stimulating testicular spermatozoa after thawing. Its immediate effect allows for faster and more accurate selection of viable sperm, which in turn improved fertilization and pregnancy outcome in this prospective study.
authors.affiliation: Landes-Frauen-und Kinderklinik Linz, Kinderwunsch Zentrum, Linz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ebner
authors.forename: Gernot
authors.initials: G
authors.lastname: Tews
authors.forename: Richard B
authors.initials: RB
authors.lastname: Mayer
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ziehr
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Arzt
authors.forename: Walter
authors.initials: W
authors.lastname: Costamoling
authors.forename: Omar
authors.initials: O
authors.lastname: Shebl
mesh_terms: D000465:Algorithms; D002478:Cells, Cultured; D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D005615:Freezing; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000628:therapy; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012662:Semen Preservation; D013081:Sperm Motility / Q000187:drug effects*; D053625:Sperm Retrieval; D013268:Stimulation, Chemical; D013806:Theophylline / Q000031:analogs & derivatives / Q000494:pharmacology*; D014970:Xanthines / Q000494:pharmacology
chemical_list: D010726:Phosphodiesterase Inhibitors; D014970:Xanthines; D013806:Theophylline