Live birth rates after MESA or TESE in men with obstructive azoospermia: is there a difference?

Background: Failed oocyte activation following intracytoplasmic sperm injection (ICSI) as a result of calcium deficiency is a major challenge. Objective: We compared the effect of cult-active medium (CAM) on ICSI outcomes in obstructive azoospermia cases. Materials and Methods: The present study was conducted with 152 ICSI cases, classified into CAM and control groups. The injected oocytes in the control group were cultured in the cleavage medium, while in the artificial oocyte activation group, oocytes were chemically activated through exposure to 200 µL of CAM for 15 min. Fertilization and cleavage rates, quality of embryos, and biochemical pregnancy and live birth rates were assessed in both groups. Results: There were significant differences between the groups in terms of fertilization and cleavage rates after using the CAM in the percutaneous epididymal sperm aspiration (PESA) subgroup (p = 0.05, p ≤ 0.001) and in the testicular sperm extraction subgroup (p = 0.02, p = 0.04), compared to their control groups. Also, the pregnancy rate was significantly higher in the PESA-CAM subgroup (p = 0.03). The PESA-CAM subgroup demonstrated a significant difference in embryo quality after ICSI (p = 0.04). Unsuccessful embryo transfer and abortion were lower in both subgroups compared to the control groups, but this difference was not significant. Surprisingly, live birth rate was higher in the PESA-CAM subgroup (p = 0.03). Conclusion: CAM treatment could improve fertilization and cleavage rates in obstructive azoospermia participants. It had a significant effect on embryo quality, and pregnancy and live birth rates in PESA cases. Key words: Calcium ionophore, Obstructive azoospermia, Fertilization, ICSI.

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Cryopreservation of testicular biopsies in men with obstructive azoospermia yields good pregnancy and live birth rates

Fertility and Sterility ◽

10.1016/j.fertnstert.2004.07.698 ◽

2004 ◽

Vol 82 ◽

pp. S262 ◽

Cited By ~ 1

Author(s):

J.M. Larson ◽

D.E. Battaglia ◽

K.A. Burry ◽

E.K. Fuchs

Keyword(s):

Live Birth ◽

Obstructive Azoospermia ◽

Birth Rates ◽

Live Birth Rates

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Fresh Versus Frozen Testicular Sperm Samples in Microdissection Testicular Sperm Extraction Intracytoplasmic Sperm Injection Treatment

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2016.636 ◽

2017 ◽

pp. 1

Author(s):

Şafak Hatırnaz ◽

Serdar Başaranoğlu ◽

Ebru Hatırnaz ◽

Mine Kanat Pektaş

Keyword(s):

Clinical Outcomes ◽

Live Birth ◽

Intracytoplasmic Sperm Injection ◽

Clinical Pregnancy ◽

Testicular Sperm Extraction ◽

Obstructive Azoospermia ◽

Testicular Sperm ◽

Birth Rates ◽

Live Birth Rates ◽

Significant Difference

Objective: The present study aims to compare the clinical outcomes of fresh versus frozen testicular samples in patients with non-obstructive azoospermia who would undergo intracytoplasmic sperm injection procedure. Study Design: This is a retrospective review of 541 patients with non-obstructive azoospermia who consecutively underwent microdissection testicular sperm injection and intracytoplasmic sperm injection between January 2010 and October 2014. Results: A total of 4896 mature oocytes were collected from the partners of azoospermic men and 1894 sperms were retrieved by microdissection testicular sperm procedures. About 1036 fresh sperms were used to perform intracytoplasmic sperm injection in 296 men with non-obstructive azoospermia whereas 858 in 245 azoospermic men. Approximately 1228 embryos were obtained after intracytoplasmic sperm injection and 1080 embryos were transferred. After embryo transfer, 146 clinical pregnancies occurred and 125 pregnancies ended up with live birth. The fertilization, implantation, clinical pregnancy and live birth rates were respectively 44.6%, 33.4%, 28.0% and 24.7% for 296 fresh microdissection testicular sperm cycles. On the other hand, the fertilization, implantation, clinical pregnancy and live birth rates were respectively 46.5%, 32.7%, 25.7% and 21.2% for 245 frozen microdissection testicular sperm cycles. There was no statistically significant difference between the fresh and frozen microdissection testicular sperm injection cycles in aspect of fertilization, implantation, clinical pregnancy and liver birth rates (p=0.125, p=0.194, p=0.196 and p=0.182). Conclusion: The utilization of fresh and frozen sperms in microdissection testicular sperm - intracytoplasmic sperm injection cycles has similar clinical outcomes. The use of frozen sperms obtained by testicular sperm can be considered as an efficient and safe approach for avoiding unnecessary ovarian hyperstimulation and repetitious interventions on testicular tissues.

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