The influence of sperm motility and cryopreservation on the treatment outcome after intracytoplasmic sperm injection following testicular sperm extraction.
BACKGROUND
It is already known that embryo quality is a major contributing factor to the outcome of assisted reproduction techniques. This study focuses on treatment variables that might be of importance to the outcome of intracytoplasmic sperm injection following testicular sperm extraction (TESE-ICSI) in non-obstructive azoospermia.


METHODS
A retrospective cohort study was conducted at a Dutch tertiary care academic training hospital between July 2009 and December 2013. With logistic regression analysis we explored the influence of treatment variables, including testicular sperm parameters - (i) motile or tail touch spermatozoa, and (ii) use of fresh or frozen testicular semen-samples - on biochemical and ongoing pregnancy rates after single (n = 393) and double embryo transfer (n = 352).


RESULTS
Multivariate logistic regression analysis identified the rank of the TESE-ICSI attempt [odds ratio (OR) 0.8, 95% confidence interval (95% CI) 0.70-0.93], the number of embryos available for transfer (OR 1.1, 95% CI 1.06-1.19) and quality of the embryo(s) transferred (OR 12.8, 95% CI 5.00-32.67) as possible predictors of biochemical pregnancy, whereas only embryo quality (OR 16.9, 95% CI 5.23-54.87) was independently associated with ongoing pregnancy.


CONCLUSIONS
The use of cryopreserved testicular sperm does not negatively influence the ongoing pregnancy and live birth rate after TESE-ICSI. However, sperm motility seems to increase the pregnancy rate through its influence on embryo quality. Therefore, fresh TESE has no added value when there is still cryopreserved testicular sperm available. Motile sperm is preferred for injection, but the use of tail touch sperm results in an acceptable treatment outcome.
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Marloes
http://orcid.org/0000-0001-5823-7922
M
Hessel
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Johanna C M
http://orcid.org/0000-0003-2607-6954
JC
Robben
Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
Kathleen W M
http://orcid.org/0000-0002-6735-3682
KW
D'Hauwers
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Didi D M
http://orcid.org/0000-0002-0847-3684
DD
Braat
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Liliana
http://orcid.org/0000-0002-4269-013X
L
Ramos
D000328:Adult; D015925:Cryopreservation; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012662:Semen Preservation; D020554:Sperm Injections, Intracytoplasmic; D013081:Sperm Motility; D016896:Treatment Outcome
Male infertility; cryopreservation; pregnancy rate; sperm motility; sperm retrieval