Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies

Background Azoospermic patients have benefited from both epididymal and testicular spermatozoa intracytoplasmic sperm injection (ICSI) treatment and lasers have been used to identify viable, immotile spermatozoa before the procedure. There are limited studies on the safety of laser-assisted selection of immotile spermatozoa. The aim of this study was to investigate the impact of laser-assisted selection of immotile spermatozoa on the obstetric and neonatal outcomes after ICSI. Methods A retrospective comparative study was conducted on outcomes of ICSI cycles with testicular spermatozoa from June 2014 to June 2018. Of 132 cycles, 33 were allocated to the test group and oocytes were injected with immotile spermatozoa selected by laser, 99 cycles were allocated as control group. Results Compared with the control group, no significant differences were found in the pregnancy, implantation, miscarriage and live birth rates in the test group in either fresh or frozen transfer cycles. The cumulative live birth rate in the test group was 69.70%, which was slightly higher than in the control group (60.61%), but this was not statistically different. There were no differences in the average gestational age, premature birth rate, neonatal birth weight, and the malformation rate between the test and control groups (P > 0.05). In addition, the obstetric outcome between the two groups were not different (P > 0.05). Conclusions No negative effect on perinatal and neonatal outcomes was seen by using laser-assisted selection of immotile spermatozoa for TESA-ICSI. This study endorses the use of laser-assisted selection of viable spermatozoa for ICSI cycles.

Successful birth after ICSI with testicular immotile spermatozoa from a patient with total MMAF in the ejaculates: a case report

Summary There has been no report on the outcome of vitrified blastocyst transfer from a vitrified oocyte injected with immotile testicular spermatozoa with only multiple morphological abnormalities of the sperm flagella (MMAF). A couple diagnosed with MMAF returned to the clinic to attempt pregnancy using their vitrified oocytes. Testicular spermatozoa were injected intracytoplasmically, and the following intracytoplasmic sperm injection results were observed. In the second cycle, surplus vitrified oocytes and testicular retrieved sperm were used, but no pregnancy ensued. In the third cycle, a surplus vitrified blastocyst was transferred, and a healthy female child was delivered, with a birth weight of 3050 g and a birth length of 53 cm. In this report we describe a successful pregnancy achieved in a patient presenting MMAF. The successful pregnancy was obtained from vitrified oocytes microinjected with testicular retrieved sperm in a vitrified blastocyst transfer.

P–010 Timing of TESE does not affect laboratory outcomes

Study question What is the outcome of intracytoplasmic sperm injection (ICSI) using testicular spermatozoa obtained on the day of oocyte pick-up (OPU) or the day before OPU. Summary answer Testicular spermatozoa were obtaining the one day before OPU does not affect fertilization rate, top quality embryo on day 3, and blastocyst utilization rate. What is known already Usually, TESE is performed just before OPU. OPU is generally cancelled if no sperm is retrieved. The use of fresh testicular spermatozoa, obtained the day before OPU could offer the couple and the caring team both medical and practical advantages. The benefits of this approach, however, has not been evaluated in detail. An uncontrolled preliminary study has revealed that regular fertilization and pregnancy rates could be achieved with sperm extraction performed one day before OPU. Study design, size, duration This was a single-center retrospective study in Bahceci BIH IVF center. Sixty-six patients suffering from azoospermia from January 2015 to December 2020 were evaluated. TESE was performed either on the OPU day (43 patients; group A) or one day before OPU (23 patients; group B). Participants/materials, setting, methods In this study, primary outcomes were motile spermatozoa at ICSI, fertilization, top quality embryo on day 3, and blastocyst utilization rate. Statistical analyses were performed with chi-squared tests. Main results and the role of chance There is no statistical difference fertilization rate (72.3% vs. 72.2, p > 0.05), top quality embryo rate on day 3 (58.3% vs 58.3%, p > 0.05) and blast utilization rate (43.98% vs 49.58%, p > 0.05) between group A and B, respectively. Limitations, reasons for caution The retrospective nature of this study may not eliminate potential bias. On the contrary, the strength of our study is that all procedures were performed by the same operators, so there are no operator-dependent differences. More research is needed to prove our findings. Wider implications of the findings: TESE procedure can be performed one day before OPU without compromising success. Trial registration number 1

P–023 Innovative ultra-rapid vitrification method for five or fewer testicular spermatozoa from non-obstructive azoospermic men after microsurgical testicular sperm extraction (Micro-TESE)

Study question What technique can be used to successfully cryopreserve five or fewer testicular spermatozoa from non-obstructive azoospermic men? Summary answer This method for cryopreserving five or fewer spermatozoa from non-obstructive azoospermic men showed a recovery rate above 90% and a survival rate of about 70%. What is known already Clinical outcomes of ICSI when using only five or fewer testicular spermatozoa after cryopreservation have been unsuccessful and are considered to be inferior to those using testicular fresh spermatozoa from Micro-TESE. A possible cause of these poor results has been the lack of a successful freezing technique. In these cases, repeated Micro-TESE and simultaneous oocyte pick up has been the only available treatment. Study design, size, duration Evaluation of the efficiency of cryopreservation by modified permeable cryoprotectant-free vitrification method (HTF supplemented with 0.1M sucrose and 10% SPS) for five or fewer testicular spermatozoa from 113 non-obstructive azoospermic men using Micro-TESE was conducted retrospectively at St. Mother Clinic between 2011 and 2018. Participants/materials, setting, methods This study included 113 non-obstructive azoospermic men. Each motile spermatozoon was carefully aspirated tail first into the pipette, put into a 2-μl microdroplet media of the vitrification medium near the tip of the Cryotop (Kitazato Corporation, Tokyo, Japan) submerged in liquid nitrogen vapor for 2 min and then immediately plunged in liquid nitrogen. The vitrified spermatozoa were warmed by dipping them into a droplet media. Successfully recovered motile sperm were selected and used for ICSI. Main results and the role of chance Number of patients, transfer cycles and collected sperms were 113, 192 and 560. Mean age of patients and their wives were 32.0±3.7y and 28.4±5.8y. Clinical pregnancy rate, miscarriage rate, live birth rate and number of live offspring were 24.0% (46/192), 19.6% (9/46), 19.3% (37/192) and 37 (Male: Female = 17: 20). Sperm recovery rate and survival rate were 90.3% (506/560) and 70.4% (356/506). Fertilization rate and mean number of transferred embryos were 51.6% (99/192) and 1.73 (1–2). Mean gestational weeks and mean body weight at birth were 39.23±5.27w and 2852.31±314.28g. No congenital anomalies were observed in any of the babies. Limitations, reasons for caution The maximum number of spermatozoa to which this method can be applied successfully is about 10. When the number of aspirated spermatozoa is over 10, some of them change direction and reach the mineral oil, and once this happens, they cannot be expelled out of the pipette. Wider implications of the findings: This technique is very useful for the cryopreservation of very small numbers of testicular spermatozoa (fewer than 10) in order to avoid or reduce Micro-TESE interventions. Trial registration number N/A

Uji Efek Ekstrak Bawang Dayak (Eleutherine Americana Merr) Terhadap Motilitas Progresif 3 Spermatozoa

<p><strong>Abstract</strong></p><p><strong> </strong></p><p><strong>Background:</strong> <em>Dayak</em> onion extract can be used as antioxidants in reducing lead toxicity. This study aims to prove the potential of <em>dayak</em> onion in inhibiting decrease of motility testicular spermatozoa of mice induced by lead acetate.</p><p><strong>Method:</strong> This study was a laboratory experimental study using Posttest Only Control Group Design design. The experimental animals were 30 mice (Mus musculus), divided into 5 groups. The K0 group was a negative control group receiving a Na-CMC 0,5% for 38 days at 0.1 ml. Day 1-3 K1 positive control group received Na-CMC 0,5%, K2-K4 group received <em>dayak</em> onion extract, K2 of 30 mg/kgBW, K3 60 mg/kgBW, and K4 120 mg/kgBW dose. Day 4-38 K1 group received 0.1 ml lead acetate, K2-K4 received lead acetate of 0.1 ml + <em>dayak</em> onion extract, K2 of 30mg/kgBW, K3 60 mg/kgBW, and K4 120 mg/kgBW as much as 0.2 ml.</p><p><strong>Result:</strong> There is a significant differences in spermatozoa concentration between K0 group with K3, K1 with K3 and K4, K2 with K3. Spermatozoa motility progressive 3 between K0 with K1, K2, K3, K4, K1 with K2, K3, K4 showed significant differences, while Testicular MDA content between K0 with K1, K2, K3 and K4, K1 with K0 and K3 showed significant differences.</p><p><strong>Conclusion</strong><strong>:</strong> <em>Dayak</em> onion extract inhibit the decrease in spermatozoa concentration, inhibit the decrease in spermatozoa motility, and decrease testicular MDA level in mice induced with lead acetate.</p><p> </p><p> </p><p><strong>Keyword</strong> : lead acetate, <em>dayak</em> onion extract, spermatozoa motility</p>

Successful intracytoplasmic sperm injection with testicular spermatozoa using pentoxifylline and HOS from a male with necrozoospermia: a case report

The study was done to compare fertilization, cleavage, and pregnancy outcome of a man affected with necro zoospermia using pentoxifylline and a hypoosmotic swelling (HOS) test to select viable spermatozoa from testicular biopsy specimens. A patient was diagnosed with necrozoospermia by semen analysis, and testicular spermatozoa were injected intracytoplasmically, using pentoxifylline and HOS (Hypo osmotic swelling test) and the following ICSI results were observed. Significantly higher fertilization rates (pentoxifylline 100% vs HOS 80%) were observed. There was no significant difference observed in cleavage rates among both groups. Finally, a healthy female infant with birth weight 3 kg was delivered at the second frozen embryo transfer cycle.it was found that selecting viable spermatozoa using pentoxifylline was more effective in fertilization and pregnancies than obtaining it through a HOS test. ICSI is effective for necrozoospermic man.

Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies

Background Azoospermic patients have benefited from both epididymal and testicular spermatozoa intracytoplasmic sperm injection (ICSI) treatment and lasers have been used to identify viable but immotile spermatozoa before the procedure. However, there are limited studies on the safety of laser-assisted selection of immotile spermatozoa. The aim of this study was to investigate the impact of laser-assisted selection of immotile spermatozoa on the obstetric and neonatal outcomes after ICSI. Methods A retrospective comparative study was conducted on patients who underwent ICSI treatment with testicular spermatozoa in our Reproductive Medicine Unit from June 2014 to June 2018. The 132 cycles were divided into two groups according to whether laser-assisted selection of spermatozoa was used. Results Compared with control group, no significant differences were found in the pregnancy, implantation, miscarriage and live birth rates in the laser group in either fresh or frozen transfer cycles. The cumulative live birth rate in the laser group was 69.70%, which was slightly higher than in the control group (60.61%), but this was not statistically different. There were no differences in the average gestational age, premature birth rate, neonatal birth weight and the malformation rate between the laser and control groups (P > 0.05). In addition, the obstetric outcome between the two groups were not different (P > 0.05). Conclusions No negative effect on perinatal and neonatal outcomes was seen by using laser-assisted selection of immotile spermatozoa for TESA-ICSI. This study endorses the use of laser-assisted selection of viable spermatozoa for ICSI cycles.