title: Chromosome abnormalities in embryos derived from microsurgical epididymal sperm aspiration and testicular sperm extraction.
abstract: OBJECTIVE
  To evaluate the patterns of chromosome abnormalities in embryos derived from intracytoplasmic sperm injection (ICSI) in microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in comparison to embryos that are derived from naturally ejaculated (EJAC) patients.
  
  
  METHODS
  Male partners with azoospermia who required MESA or TESE for ICSI were studied for chromosomal abnormalities. The ICSI patients with EJAC sperm served as the control group. Preimplantation genetic diagnosis (PGD) was performed by fluorescence in situ hybridization (FISH). Chromosome abnormalities were categorized as polyploidy, haploidy, aneuploidy, and complex abnormality (which involves more than two chromosomes). Fertilization, embryo development, and patterns of chromosome abnormalities were accessed and evaluated.
  
  
  RESULTS
  There was no difference between the MESA, TESE, and EJAC patient groups in the rates of fertilization and pregnancy and the percentages of euploid embryos. In all three groups, less than one-half of the embryos for each group were normal (41 ± 31%, 48 ± 38%, and 48 ± 31% in MESA, TESA, and EJAC, respectively). Complex chromosomal abnormality was significantly more frequent in the MESA group than in the EJAC group (48.3% vs. 26.5%, respectively; p < 0.001). Furthermore, the overall pattern of chromosomal aneuploidy was similar among all three studied groups.
  
  
  CONCLUSIONS
  We suggest that MESA and TESE, followed by ICSI and PGD, appear to be acceptable approaches for treating men with severe spermatogenesis impairment.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
authors.forename: Shao-Ping Fred
authors.initials: SP
authors.lastname: Weng
authors.affiliation: ART Reproductive Center, Beverly Hills, CA, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Surrey
authors.affiliation: ART Reproductive Center, Beverly Hills, CA, USA.
authors.forename: Hal C
authors.initials: HC
authors.lastname: Danzer
authors.affiliation: ART Reproductive Center, Beverly Hills, CA, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Hill
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: tcjwu@mednet.ucla.edu.
authors.forename: Tsung-Chieh Jackson
authors.initials: TC
authors.lastname: Wu
mesh_terms: D000328:Adult; D000782:Aneuploidy; D053713:Azoospermia / Q000628:therapy; D001757:Blastomeres; D002869:Chromosome Aberrations; D004542:Ejaculation; D005260:Female; D005820:Genetic Testing; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D011003:Ploidies; D011247:Pregnancy; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval
keywords: chromosome complement; microsurgical epididymal sperm aspiration; preimplantation genetic diagnosis; severe male infertility; testicular sperm extraction