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

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

<p><strong>Objective:</strong> 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.<br /><strong>Study Design:</strong> 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.<br /><strong>Results:</strong> 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).<br /><strong>Conclusion:</strong> 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.</p>

scholarly journals The effect of cult-active medium on pregnancy outcomes after intracytoplasmic sperm injection in azoospermic men: A case-control study

2022 ◽  
pp. 1059-1066
Author(s):  
Elham Asa ◽  
Rahil Janatifar ◽  
Seyedeh Saeideh Sahraei ◽  
Atefeh Verdi ◽  
Naser Kalhor
Keyword(s):  
Active Medium ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Embryo Quality ◽  
Obstructive Azoospermia ◽  
Oocyte Activation ◽  
Control Groups ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant 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.

P–671 Dual Trigger(low adjuvant HCG4h after GnRHagonist trigger)have positive impact of overall embryo’s quality, implantation ,clinical pregnancy and live birth rates in high-risk patients for OHSS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Petanovsk. Kostova
Keyword(s):  
High Risk ◽  
Live Birth ◽  
Clinical Pregnancy ◽  
Birth Rates ◽  
High Risk Patients ◽  
Live Birth Rates ◽  
Significant Difference ◽  
Risk Patients ◽  
Group A ◽  
Group B

Abstract Study question Study aim is to compare implantation,clinical pregnancy and livebirth rates between giving1500IU of hCG4hours after GnRHagonist,on trigger day or GnRHagonist as alone trigger with luteal support withHCG1500IU.35h later on OPUday. Summary answer Adjuvant doze of1500IUhCG4h after bolus of GnRHagonist on trigger day significantly improve quality of blastocyst,implantation,clinical pregnancy and live birth rates without increasing the risk ofOHSS. What is known already The use of GnRHagonist for final oocyte maturation in antagonist cycle significantly decrease the incidence of OHSS,but there have been studies showing lower pregnancy rates in patients triggered with GnRHagonist compared with hCG in autologous cycles,attributed to a defective luteal phase, especially in high–risk patients despite intensive luteal phase support.To improve the results of IVF,an alternative approach is adding a small bolus dose of hCG(1500IU)35h later,on the OPU day after GnRHagonist trigger which provides more sustained support for the corpus luteum.The question is does low doses of hCGgiven on the same day with GnRHagonist trigger is making better quality oocytes. Study design, size, duration Single center prospective longitudinal cohort study fromJanuary2017 to Decembar2019.The initial inclusion criteria were:women age≥18and≤39years,AMH≥3,3ng/ml and ≥12 antral follicles on basal ultrasound.Patients with history of OHSS and PCO are also included in the study.Patients with applied “freeze-all” technique with peak estradiol≥4000pg/ml on trigger day&gt;18oocytes on the OPU day,and recognized significant risk for developing OHSS were also included.The cumulative implantation,clinical pregnancy and live birth rates were analyzed,only in embryos from the same COS protocol in every patient. Participants/materials, setting, methods A total of 231 patients were entered for final analysis,who underwent a flexible antagonist protocol,ICSI and fresh or thawed ET on 3th(38.53%) or 5th( 61.47%)day in women’s autologous cycles.Patients were randomized in one of two groups: GroupA-Dual trigger group 1500IUof hCG 4h after GnRH agonist application on trigger day and GroupB –1500IU of HCG 35h later,on the OPU day.We used nonparametric and parametric statistical tests.Significant differences were considered all values ​​of p &lt; 0.05 Main results and the role of chance Both groups are homogenous regarding several variables:age,BMI,type of sterility,smoking status,AMH,PCO, spermogram.There is no significant difference between the two(AvsB)groups according to average number of retrieved oocytes(13.6 vs 14.6 p &gt; 0,05),M II oocytes(11.03 vs 11.99 p &gt; 0.05).The dual trigger group(A)had a higher fertility rate(69.99% vs 64.11% p &lt; 0,05)compared with GnRHagonist trigger group(B).There are no significant difference between groups(AvsB)according to cumulative average number of:transferred embryos(2.4vs2.5 p &gt; 0.05)TQE transfered on 3th day(1.5.vs 1.3.p&gt;0.05);transferred blastocyst(2.6 vs2.7 &gt;0.05);cryo embryos(2.5vs1.9 p &gt; 0.05),but there are significant difference according to cumulative implantation rate of transferred blastocyst in favor of group A(48.18% vs 33.89%p&lt;0.05).Analyzes of morphological characteristics of transferred blastocyst depicted in the order of degree of blastocyst expansion,inner cellular mass(ICM)and trofoectoderm(TE) and ranking overall blastocysts quality from“excellent”,“good”,“average” and “pore” ,shows that there are significantly more percentage of patient with embryo transfer of “excellent” or even one “excellent” blastocyst in group A (30.56%,31.94% vs 21.54%,23.08% p &lt; 0.05) in opposite of percentage of patients with embryo transfer with “poore “” blastocyst in group B (37.5% vs 46.15.%p&lt;0.05). Clinical pregnanacy rate (71.68% vs 50.84% p &lt; 0.05) , and live birth rate (60,18% vs 42,58% ), were significantly higher in group A. There were no cases of moderate or severe OHSS in both groups. Limitations, reasons for caution Dual trigger in GnRH antagonist protocols should be advocated as a safe approach but undetected high risk patients are reasons for caution for developing clinically significant OHSS. Wider implications of the findings: Adjuvant low dose of hCG on GnRHagonist trigger day improve clinical pregnancy and live birth rates without increasing the risk of clinically significant OHSS.Protocol of dual trigger and freezing all oocytes or embryos in patients with high risk of developing OHSS is promising technique in everyday practice. Trial registration number 8698

scholarly journals Outcomes of Intracytoplasmic Sperm Injection Cycles for Complete Teratozoospermia: A Case-Control Study Using Paired Sibling Oocytes

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Nigel Pereira ◽  
Queenie V. Neri ◽  
Jovana P. Lekovich ◽  
Steven D. Spandorfer ◽  
Gianpiero D. Palermo ◽  
...  
Keyword(s):  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Sperm Morphology ◽  
Male Partner ◽  
Clinical Pregnancy ◽  
Semen Parameters ◽  
Birth Rates ◽  
Spontaneous Miscarriage ◽  
Sibling Oocytes ◽  
Live Birth Rates

Objective. To investigate the outcomes of intracytoplasmic sperm injection (ICSI) cycles where sibling oocytes from a single donor were split between two recipients based on strict sperm morphology.Methods. Retrospective cohort study. All ICSI cycles had one donor’s oocytes split between two recipients in a 1 : 1 ratio based on strict sperm morphology, that is, one male partner had morphology of 0% and the other had morphology of >1%. Fertilization, positive hCG, clinical pregnancy, spontaneous miscarriage, and live birth rates of the aforementioned groups were compared.Results. The baseline characteristics of the two groups (n=103), including semen parameters of the male partners, were comparable. There was no difference in the fertilization rates when comparing the 0% group to the >1% group (78.7% versus 81.6%;P=0.66). The overall positive hCG, clinical pregnancy, spontaneous miscarriage, and live birth rates for the 0% group were 61.2%, 49.5%, 10.7%, and 38.8%, respectively. The corresponding rates in the >1% group were positive hCG (63.1%), clinical pregnancy (55.3%), spontaneous miscarriage (7.77%), and live birth (46.6%).Conclusions. The fertilization and pregnancy outcomes of ICSI cycles for strict sperm morphology of 0% versus morphology of >1% are equivalent. These results can provide reassurance to couples undergoing ICSI for severe teratospermia.

scholarly journals Intracytoplasmic sperm injection with fresh versus cryopreserved testicular sperm in azoospermic patients

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Kani M. Falah
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Obstructive Azoospermia ◽  
Testicular Sperm

Abstract Background The purpose of this study is to compare the outcome of intracytoplasmic sperm injection (ICSI) using fresh sperm versus frozen-thawed sperm in both obstructed and non-obstructed azoospermias. This retrospective study included 159 ICSI cycles from 126 couples. In 91 obstructed azoospermia cases, 66 cycles were treated with fresh testicular sperm and 25 cycles were treated with frozen-thawed testicular samples. In 68 non-obstructed azoospermia cases, 32 cycles were treated with fresh testicular sperm and 36 cycles were treated with frozen-thawed testicular sperm, and the main measure and outcomes calculated are fertilization rate, clinical pregnancy, and live birth rate. Results In case of obstructed azoospermia, there were no statistically significant differences between fresh sperm and frozen-thawed testicular sperm used for ICSI regarding fertilization rate, clinical pregnancy rate, and live birth rate as shown (57%, 47%, 0.093 p value; 23.7%, 17.4%, 0.54 p value; and 11.9%, 8.7%, 0.68 p value, respectively). Non-obstructed azoospermia cases also show no significant differences in fertilization rate (37%, 36%, 0.91 p value), clinical pregnancy rate (20%, 14.3%, 0.58 p value), and live birth rate (4%, 3.6%, 0.93 p value). Conclusion Cryopreservation of testicular sperm is reliable if carried out before ovulation induction especially in cases with non-obstructive azoospermia

scholarly journals Clinical Outcomes of Frozen-Thawed Embryos Generated From Growth Hormone Stimulation in Expected Poor Responders

2021 ◽  
Vol 11 ◽  
Author(s):  
Jinliang Zhu ◽  
Ying Wang ◽  
Lixue Chen ◽  
Ping Liu ◽  
Rong Li ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Adjuvant Therapy ◽  
Clinical Outcomes ◽  
Live Birth ◽  
Clinical Pregnancy ◽  
Poor Responders ◽  
Control Groups ◽  
Birth Rates ◽  
Live Birth Rates ◽  
And Control

ObjectiveThis study aimed to elucidate whether growth hormone (GH) adjuvant therapy significantly improves clinical outcomes for expected poor responders in frozen-thawed cycles.MethodsExpected poor responders undergoing controlled ovarian stimulation with or without GH adjuvant therapy, and subsequently underwent the first frozen-thawed transfer from January 2017 to March 2020 were retrospectively reviewed. Maternal age was matched at a 1:1 ratio between the GH and control groups. All statistical analyses were performed with the Statistical Package for the Social Sciences software.ResultsA total of 376 frozen-thawed cycles comprised the GH and control groups at a ratio of 1:1. The number of oocytes (7.13 ± 3.93 vs. 5.89 ± 3.33; p = 0.001), two pronuclei zygotes (4.66 ± 2.76 vs. 3.99 ± 2.31; p = 0.011), and day 3 available embryos (3.86 ± 2.62 vs. 3.26 ± 2.04; p = 0.014) obtained in the GH group was significantly higher than the control group in corresponding fresh cycles. The clinical pregnancy (30.3 vs. 31.0%; p = 0.883), implantation (25.3 vs. 26.2%; p = 0.829), early abortion (16.1 vs. 15.8%; p = 0.967), and live birth rates (20.6 vs. 20.8%; p=0.980) were comparable between the two groups in frozen-thawed cycles. Improvement in the clinical pregnancy (46.8 vs. 32.1%; p = 0.075), early miscarriage (10.3 vs. 20.0%; p = 0.449), and live birth rates (35.7 vs. 18.9%; p = 0.031) was found in the subgroup of poor ovarian responders (PORs) with good quality blastocyst transfer (≥4BB) following GH co-treatment.ConclusionsGH administration would increase oocyte quantity and quality, in turn, improve live birth rate in PORs.

scholarly journals Effect of Laser-Assisted Hatching on the Clinical Outcomes of Human Vitrified-Thawed Embryo Transfer Cycles with Different Post-Thaw Culture Duration

2020 ◽  
Author(s):  
Yang Luo ◽  
Fang Peng ◽  
Yuan Sun ◽  
Lei Li
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Ectopic Pregnancy ◽  
Live Birth ◽  
Perinatal Outcomes ◽  
Clinical Pregnancy ◽  
Assisted Hatching ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Abstract Background: Zona pellucida(ZP)hardening caused by prolonged in vitro culture and exacerbated by the freeze–thaw process making ZP hatching difficult; In theory, assisted hatching may facilitate the hatching process and have the potential to increase implantation and/or pregnancy rates in frozen embryo transfer (FET) cycles. However, a number of studies have shown controversial results on the clinical benefit of laser-assisted hatching (LAH) in FET cycles. This study firstly investigated the efficacy and safety of LAH using vitrified-thawed embryos with different post-thaw culture duration in FET cycles.Methods: Data from the center’s IVF database were retrospectively analyzed, only embryos thawed for the first FET cycle of each ovarian pick-up were eligible for this study, and only cycles in which at least one embryo was available for transfer were included in the present study. Finally, a total of 1225 infertile couples who underwent 1225 FET cycles between July 2013 and March 2015 were analyzed in this study. According to the duration of post-thaw culture in FET cycles, these patients were allocated to three subgroups: the short culture (4-5 h) group (LAH, n=205; control, n=201), overnight culture (20-24 h) group (LAH, n=197; control, n=203), and blastocyst culture (44-48 h) group (LAH, n=210; control, n=209), respectively.Results: In the short culture(4-5 h) subgroup, no statistically significant differences were found related to the implantation, clinical pregnancy and live birth rates between the two groups (28.0% versus 27.8%, 38.0% versus 36.8%, and 30.7% versus 30.3%, respectively, P＞0.05). When the perinatal outcomes of two groups were compared, there was no significant difference in the gestational weeks (37.96±2.23 versus 37.59±2.35, P＞0.05), birth weight (2.70±0.56 versus 2.82±0.62, P＞0.05), as well as the preterm birth (15.4% versus 17.6%, P＞0.05), ectopic pregnancy (2.6% versus 1.4%, P＞0.05), and miscarriage rates (16.7% versus 16.2%, P＞0.05).In the overnight culture(20-24 h) subgroup, no statistically significant differences were found regarding the implantation, clinical pregnancy and live birth rates (29.5% versus 29.1%, 40.1%versus 37.4%, 33.0%versus 30.5%, respectively, P＞0.05).As to the perinatal outcomes, there was no significant difference in the gestational weeks (36.86±2.28 versus 35.69±2.95, P＞0.05), birth weight (2.73±0.76 versus2.62±0.52, P＞0.05), as well as the preterm birth (15.2% versus 17.1%, P＞0.05), ectopic pregnancy (3.8% versus 2.6%, P＞0.05), and miscarriage rates (13.9% versus 15.8%, P＞0.05).In the blastocyst culture(44-48 h) subgroup, the two groups did not differ significantly in the implantation, clinical pregnancy and live birth rates (56.3% versus 59.3%, 68.6% versus 66.5%, and 55.7% versus56.5%, respectively, P＞0.05).Furthermore, there were also no significant difference in the gestational weeks (38.68±2.76 versus 36.95±2.59, P＞0.05), birth weight (2.78±0.74 versus 2.72±0.59, P＞0.05), as well as the preterm birth (8.3% versus 11.5%, P＞0.05), ectopic pregnancy (2.8% versus 2.2%, P＞0.05), and miscarriage rates (16.0% versus 12.9%, P＞0.05).Conclusions: Our results suggested that LAH does not improve the clinical outcomes in FET cycles, irrespective of the duration of post-thaw culture. Though the risk of perinatal period did not increase, it is still necessary to conduct further investigations to validate the safety of LAH.

scholarly journals Clinical Outcomes and Live Birth Rate (LBR) of Micro-TESE With ICSI-IVF in 968 Non-obstructive Azoospermia Patients From One Reproductive Medicine Center: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Yu Lan ◽  
Haiyan Zheng ◽  
Xin Fu ◽  
Tianwen Peng ◽  
Chen Liao ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Sperm Count ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Significant Difference ◽  
Intent To Treat

Abstract Background: Most of data available in the literature reported the sperm retrieval rate (SRR) and ICSI results of microdissection testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients with different etiologies. Unfortunately, there is currently a lack of comprehensive Intent-to-treat (ITT) data to guide clinicians in conducting comprehensive consultations with NOA patients. The aim of current study was to obtain more comprehensive evidence-based data and clinical outcomes for better consultation of NOA patients who opted to undergo micro-TESE combined with ICSI-IVF.Materials and methods: A retrospective study involved 968 NOA patients underwent micro-TESE during the period between January 2015 and December 2019. Those who had successful sperm retrieval and performed ICSI-IVF cycles were included in intent-to-treat (ITT) analysis. The primary outcome measure was the live birth rate (LBR). The cumulative pregnancy or live birth was defined as clinical pregnancy or at least one live-born baby resulting from an ICSI initiated cycle. Two kinds of stratification analyses were performed based on different etiologies of NOA and various amounts of sperm retrieved. The 'Student's t-test was used for comparison of continuous variables. One-way ANOVA was used to assess outcomes among more than two groups. Chi-squared (χ2) or Fisher's exact test was used for proportions.Results: The SRR of all 968 NOA patients undergoing micro-TESE was 44.6% (n=432). ITT analysis was performed in 424 patients, and ICSI-IVF was applied in 362 couples, leading to 171 clinical pregnancies (40.3%) and 161 live-birth deliveries (38.0%) in the first embryo transfer cycle. No significant difference was observed for per-protocol analysis between the groups of frozen sperm and fresh sperm in cumulative clinical pregnancy rate (CPR, 51.0% vs. 45.2%) and live-birth rate (LBR, 47.5% vs. 42.9%). NOA patients with Y chromosome azoospermia factor c (AZFc) microdeletions had the lowest rate of the high-score embryo on day 3 (4.4%, P<0.05) and the lowest cumulative CPR (22.2%, P<0.05). NOA patients with lower sperm count had significantly lower cumulative LBR than those with higher sperm count (25.0% vs. 49.2%, P<0.05).Conclusions: Micro-TESE is an effective sperm retrieval technique for NOA patients. Our data indicated no significant difference in the LBR between ICSI-IVF cycles using frozen or fresh testicular sperm.

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