Testicular versus ejaculated spermatozoa in ICSI cycles of normozoospermic men with high sperm DNA fragmentation and previous ART failures.
As a part of male assessment, conventional sperm parameters including morphologic features have been dedicated as major factors influencing fertilisation and pregnancy rates in assisted reproductive technology (ART). Genomic integrity of spermatozoa has also been found to influence fertility prognosis, and hence, sperm DNA fragmentation index (DFI) has been adopted by many centres to document this entity. Despite several suggested approaches, there is lack of universal consensus on optimising fertility outcomes in males with high sperm DFI. In this context, the results from cycles using testicular spermatozoa (TESA) obtained by aspiration were compared with those of ejaculated spermatozoa (EJ) in normozoospermic subjects with high sperm DFI and previous ART failures. Clinical (41.9% versus 20%) and ongoing pregnancy rates (38.7% versus 15%) were significantly better and miscarriages were lower in TESA group when compared to EJ group. Sperm DFI should be a part of male partner's evaluation following unsuccessful ART attempts. When high DFI is detected (>30%), ICSI using testicular spermatozoa obtained by TESA seems an effective option particularly for those with repeated ART failures in terms of clinical, ongoing pregnancies and miscarriages even though conventional sperm parameters are within normal range.
Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
E G
EG
Pabuccu
Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
G S
GS
Caglar
Ufuk University School of Medicine, Department of Urology, Ankara, Turkey.
S
S
Tangal
Ufuk University School of Medicine, Department of Urology, Ankara, Turkey.
A H
AH
Haliloglu
Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.|Centrum Clinic Women's Health and ART Center, Ankara, Turkey.
R
R
Pabuccu
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D053938:DNA Fragmentation; D004542:Ejaculation; D005260:Female; D005298:Fertility; D006801:Humans; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D055101:Semen Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000378:metabolism*; D013737:Testis / Q000166:cytology*; D016896:Treatment Outcome
Assisted reproductive technology; ejaculate; intra-cytoplasmic sperm injection; sperm DNA; testicular sperm aspiration