Skip to main content
SpringerLink
Log in

Potential of testicular sperm to support embryonic development to the blastocyst stage is comparable to that of ejaculated sperm

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

Recent studies have shown that improved clinical outcomes can be achieved by transferring blastocysts rather than cleavage-stage embryos. However, blastocyst transfer is not performed in all patients. The aim of this study was to compare clinical outcomes of intracytoplasmic sperm injection (ICSI) cycles using testicular sperm (TE) with those of ICSI cycles using ejaculated sperm (EJ).

Methods

ICSI was performed using EJ in 141 cycles and TE in 37 cycles. Embryos were cultured for 5 days. The quality of embryos was assessed on days 3 and 5 before embryo transfer.

Results

Fertilization rate was 77.3% in the EJ group and 69.6% in the TE group (p < 0.05). The good-quality embryos on day 3 and 5 were not different between the EJ and TE groups. Embryos did not develop to blastocyst stage in 7 cycles of the EJ group (5.0%) and 2 cycles of the TE group (5.4%). There were no significant differences in blastocyst formation and blastocyst quality (46.1% vs. 47.5% and 5.7% vs 5.8%, respectively) on day 5 between both groups. Embryos were transferred in all cycles. Implantation (22.8 vs. 24.7%), clinical pregnancy (44.7 vs. 43.2%), miscarriage (21.7 vs. 33.3%), and delivery (76.5 vs. 66.7%) did not differ between EJ group and TE group. Clinical outcomes of ICSI were not different between the EJ and TE groups.

Conclusions

In conclusion, the potential of testicular sperm supporting embryonic development to blastocysts is comparable to that of ejaculated sperm. Therefore, this study suggests that blastocyst transfer can be a very useful assisted reproductive technique in the ICSI cycles that require the use of testicular sperm, and the clinical outcomes of the cycles are comparable to those of ICSI cycles using ejaculated sperm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Janny L, Menezo YJR. Evidence for a strong paternal effect on human preimplantation embryo development and blastocyst formation. Mol Reprod Dev. 1994;38:36–42.

    Article  PubMed  CAS  Google Scholar 

  2. Shoukir Y, Chardonnens D, Campana A, Sakkas D. Blastocyst development from supernumerary embryos after intracytoplasmic sperm injection: a paternal influence? Hum Reprod. 1998;13:1632–7.

    Article  PubMed  CAS  Google Scholar 

  3. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340:17–8.

    Article  PubMed  CAS  Google Scholar 

  4. Craft I, Bennett V, Nicholson N. Fertilising ability of testicular spermatozoa. Lancet. 1993;342:864.

    Article  PubMed  CAS  Google Scholar 

  5. Schoysman R, Vanderzwalmen P, Nijs M, Segal L, Segal-Bertin G, Geerts L, et al. Pregnancy after fertilisation with human testicular spermatozoa. Lancet. 1993;342:1237.

    Article  PubMed  CAS  Google Scholar 

  6. Balaban B, Urman B, Isiklar A, Alatas C, Mercan R, Aksoy S, et al. Blastocyst transfer following intracytoplasmic injection of ejaculated, epididymal or testicular spermatozoa. Hum Reprod. 2001;16:125–9.

    Article  PubMed  CAS  Google Scholar 

  7. Rossi-Ferragut LM, Iaconelli A Jr, Aoki T, Rocha CC, dos Santos DR, Pasqualotto FF, et al. Pronuclear and morphological features as a cumulative score to select embryos in ICSI (intracytoplasmic sperm injection) cycles according to sperm origin. J Assist Reprod Genet. 2003;20:1–7.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nallella KP, Sharma RK, Aziz N, Agarwal A. Significance of sperm characteristics in the evaluation of male infertility. Fertil Steril. 2006;85:629–34.

    Article  PubMed  Google Scholar 

  9. Aziz N, Agarwal A. Evaluation of sperm damage: beyond the World Health Organization criteria. Fertil Steril. 2008;90:484–5.

    Article  PubMed  Google Scholar 

  10. Lee SH, Song H, Park YS, Koong MK, Song IO, Jun JH. Poor sperm quality affects clinical outcomes of intracytoplasmic sperm injection in fresh and subsequent frozen-thawed cycles: potential paternal effects on pregnancy outcomes. Fertil Steril. 2009;91:798–804.

    Article  PubMed  Google Scholar 

  11. Greco E, Scarselli F, Iacobelli M, Rienzi L, Ubaldi F, Ferrero S, et al. Efficient treatment of infertility due to sperm DNA damage by ICSI with testicular spermatozoa. Hum Reprod. 2005;20:226–30.

    Article  PubMed  Google Scholar 

  12. Weng SP, Surrey MW, Danzer HC, Hill DL, Chen PC, Wu TC. Chromosome abnormalities in embryos derived from microsurgical epididymal sperm aspiration and testicular sperm extraction. Taiwan J Obstet Gynecol. 2014;53:202–5.

    Article  PubMed  Google Scholar 

  13. Nilsson S, Waldenström U, Engström AB, Hellberg D. Single blastocyst transfer after ICSI from ejaculate spermatozoa, percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE). J Assist Reprod Genet. 2007;24:167–71.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Naru T, Sulaiman MN, Kidwai A, Ather MH, Waqar S, Virk S, et al. Intracytoplasmic sperm injection outcome using ejaculated sperm and retrieved sperm in azoospermic men. Urol J. 2008;5:106–10.

    PubMed  Google Scholar 

  15. Braga DP, Setti AS, Vingris L, Figueira RC, Iaconelli A, Borges E. The male factor of infertility should not be an issue for the selection of patients for extended embryo culture programmes. Andrology. 2013;1:758–63.

    Article  PubMed  CAS  Google Scholar 

  16. Xie D, Qiu Z, Luo C, Chu Q, Quan S. Effect of spermatozoa from different sources on normal fertilization of oocytes and embryo quality and development in intracytoplasmic sperm injection cycles. Nan Fang Yi Ke Da Xue Xue Bao. 2014;34:857–61.

    PubMed  Google Scholar 

  17. Gardner DK, Schoolcraft WB. In vitro culture of human blastocysts. In: Jansen R, Mortimer D, editors. Toward reproductive certainty: fertility and genetics beyond. London: Parthenon Publishing; 1999. p. 378–88.

    Google Scholar 

  18. Miller JE, Smith TT. The effect of intracytoplasmic sperm injection and semen parameters on blastocyst development in vitro. Hum Reprod. 2001;16:918–24.

    Article  PubMed  CAS  Google Scholar 

  19. Ghazzawi IM, Sarraf MG, Taher MR, Khalifa FA. Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection. Hum Reprod. 1998;13:348–52.

    Article  PubMed  CAS  Google Scholar 

  20. Pasqualotto FF, Rossi-Ferragut LM, Rocha CC, Iaconelli A Jr, Borges E Jr. Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm obtained from patients with obstructive and nonobstructive azoospermia. J Urol. 2002;167:1753–6.

    Article  PubMed  Google Scholar 

  21. Hauser R, Yogev L, Paz G, Yavetz H, Azem F, Lessing JB, et al. Comparison of efficacy of two techniques for testicular sperm retrieval in nonobstructive azoospermia: multifocal testicular sperm extraction versus multifocal testicular sperm aspiration. J Androl. 2006;27:28–33.

    Article  PubMed  Google Scholar 

  22. Nagy ZP, Verheyen G, Tournaye H, Van Steirteghem AC. Special applications of intracytoplasmic sperm injection: the influence of sperm count, motility, morphology, source and sperm antibody on the outcome of ICSI. Hum Reprod. 1998;13(Suppl 1):143–54.

    Article  PubMed  Google Scholar 

  23. Shulman A, Feldman B, Madgar I, Levron J, Mashiach S, Dor J. In-vitro fertilization treatment for severe male factor: the fertilization potential of immotile spermatozoa obtained by testicular extraction. Hum Reprod. 1999;14:749–52.

    Article  PubMed  CAS  Google Scholar 

  24. Palermo GD, Schlegel PN, Hariprashad JJ, Ergün B, Mielnik A, Zaninovic N, et al. Fertilization and pregnancy outcome with intracytoplasmic sperm injection for azoospermic men. Hum Reprod. 1999;14:741–8.

    Article  PubMed  CAS  Google Scholar 

  25. Goker EN, Sendag F, Levi R, Sendag H, Tavmergen E. Comparison of the ICSI outcome of ejaculated sperm with normal, abnormal parameters and testicular sperm. Eur J Obstet Gynecol Reprod Biol. 2002;104:129–36.

    Article  PubMed  Google Scholar 

  26. Tehraninejad ES, Pourmatroud E, Sadighi Gilani MA, Rakebi M, Azimi Neko Z, Arabipoor A. Comparison of intracytoplasmic sperm injection outcomes between oligozoospermic, obstructive azoospermic and non-obstructive azoospermic patients. Int J Fertil Steril. 2012;6:13–8.

    PubMed  PubMed Central  Google Scholar 

  27. Esteves SC, Prudencio C, Seol B, Verza S, Knoedler C, Agarwal A. Comparison of sperm retrieval and reproductive outcome in azoospermic men with testicular failure and obstructive azoospermia treated for infertility. Asian J Androl. 2014;16:602–6.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Asch R, Simerly C, Ord T, Ord VA, Schatten G. The stages at which human fertilization arrests: microtubule and chromosome configurations in inseminated oocytes which failed to complete fertilization and development in humans. Hum Reprod. 1995;10:1897–906.

    Article  PubMed  CAS  Google Scholar 

  29. Simerly C, Hewitson LC, Sutovsky P, Schatten G. The inheritance, molecular dissection and reconstitution of the human centrosome during fertilization: consequences for infertility. In: Barratt C, De Jonge C, Mortimer D, Parinaud J, editors. Genetics of human male fertility. Paris: EDK Press; 1997. p. 258–86.

    Google Scholar 

  30. Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev. 2007;s17:CD002118.

    Google Scholar 

  31. Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum Reprod. 2008;23:91–9.

    Article  PubMed  Google Scholar 

  32. Virant-Klun I, Tomazevic T, Zorn B, Bacer-Kermavner L, Mivsek J, Meden-Vrtovec H. Blastocyst formation—good indicator of clinical results after ICSI with testicular spermatozoa. Hum Reprod. 2003;18:1070–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank staffs of Laboratory of Reproductive Medicine, Cheil General Hospital & Women’s Healthcare Center.

Author information

Authors and Affiliations

  1. Laboratory of Reproductive Medicine, Cheil General Hospital and Women’s Healthcare Center, Dankook University College of Medicine, 17, Seoae ro 1 Gil, Jung gu, Seoul, South Korea

    Sun-Hee Lee & Chun Kyu Lim

  2. Department of Biosciences, Institute of Basic Sciences, College of Natural Sciences, Sungshin Women’s University, Seoul, South Korea

    Sun-Hee Lee & Yong-Pil Cheon

  3. Department of Obstetrics and Gynecology, Cheil General Hospital and Women’s Healthcare Center, Dankook University College of Medicine, Seoul, South Korea

    Chan Woo Park

Authors
  1. Sun-Hee Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chan Woo Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yong-Pil Cheon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chun Kyu Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chun Kyu Lim.

Electronic supplementary material

ESM 1

(DOCX 15.7 kb)

ESM 2

(DOCX 16 kb)

ESM 3

(DOCX 15.1 kb)

ESM 4

(DOCX 14.8 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, SH., Park, C.W., Cheon, YP. et al. Potential of testicular sperm to support embryonic development to the blastocyst stage is comparable to that of ejaculated sperm. J Assist Reprod Genet 35, 1103–1111 (2018). https://doi.org/10.1007/s10815-018-1191-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-018-1191-8

Keywords

Search

Navigation