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Impact of sperm cell source on the results of intracytoplasmic sperm injection

Archives of Gynecology and Obstetrics volume 291, pages 663–669 (2015)Cite this article

Abstract

Purpose

There is an ongoing debate whether the source of sperm cells, the etiology or the extent of male factor infertility has influence on the outcome of ICSI cycles.

Methods

The results of intracytoplasmic sperm injection (ICSI) according to the source of spermatozoa in patients with severe male factor infertility were compared in a retrospective study: 249 couples underwent a total of 337 fresh ICSI cycles with the use of fresh motile testicular or fresh motile ejaculated spermatozoa.

Results

For all variables, there were no statistically significant differences in the ICSI results between both groups. Fertilization rates were 46.8 % for testicular and 47.6 % for ejaculated spermatozoa. Live birth rates per embryo transfer were 20.4 % using testicular spermatozoa and 22.8 % using ejaculated spermatozoa.

Conclusions

Neither the source of spermatozoa nor the etiology of severe male infertility has relevant impact on the results of ICSI cycles as long as fresh motile, morphologically normal spermatozoa are used. Therefore, in case of cryptozoospermia, we recommend to preferentially use ejaculated spermatozoa to prevent those men from an unnecessary testicular biopsy avoiding risks and costs implied.

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References

  1. Nagy ZP, Liu J, Joris H, Verheyen G, Tournaye H, Camus M, Derde MC, Devroey P, van Steirteghem AC (1995) The result of intracytoplasmic sperm injection is not related to any of the three basic sperm parameters. Hum Reprod 10:1123–1129

    CAS  PubMed  Google Scholar 

  2. Strassburger D, Friedler S, Raziel A, Schachter M, Kasterstein E, Ron-El R (2000) Very low sperm count affects the result of intracytoplasmic sperm injection. J Assist Reprod Genet 17:431–436

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  3. Tournaye HJ, Cohlen BJ (2012) Management of male-factor infertility. Best Pract Res Clin Obstet Gynaecol 26:769–775

    PubMed  Article  Google Scholar 

  4. French DB, Sabanegh ES Jr, Goldfarb J, Desai N (2010) Does severe teratozoospermia affect blastocyst formation live birth rate and other clinical outcome parameters in ICSI cycles? Fertil Steril 93:1097–1103

    PubMed  Article  Google Scholar 

  5. Amirjannati N, Heidari-Vala H, Akhondi MA, Hosseini Jadda SH, Kamali K, Sadeghi MR (2011) Comparison of intracytoplasmic sperm injection outcomes between spermatozoa retrieved from testicular biopsy and from ejaculation in cryptozoospermic men. Andrologia 43:317–320

    CAS  PubMed  Article  Google Scholar 

  6. Ben-Ami I, Raziel A, Strassburger D, Komarovsky D, Ron-El R, Friedler S (2013) Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men. Fertil Steril 99:1867–1871

    PubMed  Article  Google Scholar 

  7. Celikten A, Batioglu S, Gungor AN, Ozdemir E (2013) Intracytoplasmic sperm injection outcomes of obstructive and nonobstructive azoospermic men. Arch Gynecol Obstet 288:683–686

    PubMed  Article  Google Scholar 

  8. Demir B, Arikan I, Bozdag G, Esinler I, Karakoc SL, Gunalp S (2012) ICSI outcome of patients with severe oligospermia vs non-obstructive azoospermia. Clin Exp Obstet Gynecol 39:141–143

    CAS  PubMed  Google Scholar 

  9. Hauser R, Bibi G, Yogev L, Carmon A, Azem F, Botchan A, Yavetz H, Klieman SE, Lehavi O, Amit A, Ben-Yosef D (2011) Virtual azoospermia and cryptozoospermia–fresh/frozen testicular or ejaculate sperm for better IVF outcome? J Androl 32:484–490

    PubMed  Article  Google Scholar 

  10. Hourvitz A, Shulman A, Madjar I, Levron J, Levran D, Mashiach S, Dor J (1998) In vitro fertilization treatment for severe male factor: a comparative study of intracytoplasmic sperm injection with testicular sperm extraction and with spermatozoa from ejaculate. J Assist Reprod Genet 15:386–389

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  11. Madgar I, Hourvitz A, Levron J, Seidman DS, Shulman A, Raviv GG, Levran D, Bider D, Mashiach S, Dor J (1998) Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm extracted from patients with obstructive and nonobstructive azoospermia. Fertil Steril 69:1080–1084

    CAS  PubMed  Article  Google Scholar 

  12. El-Taieb MA, Herwig R, Nada EA, Greilberger J, Marberger M (2009) Oxidative stress and epididymal sperm transport motility and morphological defects. Eur J Obstet Gynecol Reprod Biol 144(Suppl 1):199–203

    Article  Google Scholar 

  13. Gharagozloo P, Aitken RJ (2011) The role of sperm oxidative stress in male infertility and the significance of oral antioxidant therapy. Hum Reprod 26:1628–1640

    PubMed  Article  Google Scholar 

  14. Henkel R, Bastiaan HS, Schuller S, Hoppe I, Starker W, Menkveld R (2010) Leucocytes and intrinsic ROS production may be factors compromising sperm chromatin condensation status. Andrologia 42:69–75

    CAS  PubMed  Article  Google Scholar 

  15. Shiva M, Gautam AK, Verma Y, Shivgotra V, Doshi H, Kumar S (2011) Association between sperm quality oxidative stress and seminal antioxidant activity. Clin Biochem 44:319–324

    CAS  PubMed  Article  Google Scholar 

  16. Tremellen K (2008) Oxidative stress and male infertility–a clinical perspective. Hum Reprod Update 14:243–258

    CAS  PubMed  Article  Google Scholar 

  17. Mahfouz R, Sharma R, Thiyagarajan A, Kale V, Gupta S, Sabanegh E, Agarwal A (2010) Semen characteristics and sperm DNA fragmentation in infertile men with low and high levels of seminal reactive oxygen species. Fertil Steril 94:2141–2146

    CAS  PubMed  Article  Google Scholar 

  18. Guyonnet B, Dacheux F, Dacheux JL, Gatti JL (2011) The epididymal transcriptome and proteome provide some insights into new epididymal regulations. J Androl 32:651–664

    CAS  PubMed  Article  Google Scholar 

  19. Kupker W, Al-Hasani S, Johannisson R, Sandmann J, Ludwig M, Jocham D, Diedrich K (2002) The use of cryopreserved mature and immature testicular spermatozoa for intracytoplasmic sperm injection: risks and limitations. Semin Reprod Med 20:25–35

    PubMed  Article  Google Scholar 

  20. Greco E, Scarselli F, Iacobelli M, Rienzi L, Ubaldi F, Ferrero S, Franco G, Anniballo N, Mendoza C, Tesarik J (2005) Efficient treatment of infertility due to sperm DNA damage by ICSI with testicular spermatozoa. Hum Reprod 20:226–230

    PubMed  Article  Google Scholar 

  21. Negri L, Patrizio P, Albani E, Morenghi E, Benaglia R, Desgro M, Levi Setti PE (2014) ICSI outcome is significantly better with testicular spermatozoa in patients with necrozoospermia: a retrospective study. Gynecol Endocrinol 30:48–52

    PubMed  Article  Google Scholar 

  22. Koksal IT, Usta M, Orhan I, Abbasoglu S, Kadioglu A (2003) Potential role of reactive oxygen species on testicular pathology associated with infertility. Asian J Androl 5:95–99

    CAS  PubMed  Google Scholar 

  23. Gnoth C, Maxrath B, Skonieczny T, Friol K, Godehardt E, Tigges J (2011) Final ART success rates: a 10 years survey. Hum Reprod 26:2239–2246

    CAS  PubMed  Article  Google Scholar 

  24. Bendikson KA, Neri QV, Takeuchi T, Toschi M, Schlegel PN, Rosenwaks Z (2008) The outcome of intracytoplasmic sperm injection using occasional spermatozoa in the ejaculate of men with spermatogenic failure. J Urol 180:1060–1064

    PubMed  Article  Google Scholar 

  25. Cocuzza M, Alvarenga C, Pagani R (2013) The epidemiology and etiology of azoospermia. Clinics (Sao Paulo) 68(Suppl 1):115–126

    Google Scholar 

  26. Esteves SC, Lee W, Benjamin DJ, Seol B, Verza S Jr, Agarwal A (2013) Reproductive potential of men with obstructive azoospermia undergoing percutaneous sperm retrieval and intracytoplasmic sperm injection according to the cause of obstruction. J Urol 189:232–237

    PubMed  Article  Google Scholar 

  27. Weissman A, Horowitz E, Ravhon A, Nahum H, Golan A, Levran D (2008) Pregnancies and live births following ICSI with testicular spermatozoa after repeated implantation failure using ejaculated spermatozoa. Reprod Biomed Online 17:605–609

    PubMed  Article  Google Scholar 

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Acknowledgments

The authors wish to thank Mrs. Sarah Johnson, SPD Development Company Ltd., Stannard, Priory Business Park, Stannard Way, Bedford, MK44 3UP, United Kingdom, for proof reading the manuscript and the IVF lab staff of green-ivf recording and preparing the row data.

Conflict of interest

The corresponding author and all co-authors have nothing to disclose. All the materials contained in the manuscript have not been published and are not being submitted elsewhere for publication. All authors agree to submission of the manuscript to Archives of Gynecology and Obstetrics.

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Affiliations

  1. Green-IVF, Grevenbroich Endocrinology and IVF-Center, Rheydter Str. 143, 41515, Grevenbroich, Germany

    Christian Gnoth, Vitaly Markhinin, Therese Skonieczny, Kerstin Friol & Judith Roos

  2. Department of Gynecology and Obstetrics, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany

    Christian Gnoth & Gohar Rahimi

  3. Amedes Experts, Moenckebergstraße 10, 20095, Hamburg, Germany

    Beatrice Maxrath

  4. Biometric Research Group, Clinic for Cardiovascular Surgery, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    Erhard Godehardt

Authors
  1. Christian Gnoth
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  2. Vitaly Markhinin
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  3. Beatrice Maxrath
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  4. Therese Skonieczny
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  5. Kerstin Friol
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  6. Judith Roos
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  7. Gohar Rahimi
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  8. Erhard Godehardt
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Correspondence to Christian Gnoth.

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Gnoth, C., Markhinin, V., Maxrath, B. et al. Impact of sperm cell source on the results of intracytoplasmic sperm injection. Arch Gynecol Obstet 291, 663–669 (2015). https://doi.org/10.1007/s00404-014-3448-5

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  • DOI: https://doi.org/10.1007/s00404-014-3448-5

Keywords

  • Male factor infertility
  • Azoospermia
  • Cryptozoospermia
  • Testicular sperm extraction (TESE)
  • Intracytoplasmic sperm injection (ICSI)
  • Sperm cell source