TESTICULAR VERSUS EPIDIDYMAL SPERMATOZOA IN INTRACYTOPLASMIC SPERM INJECTION TREATMENT CYCLES
AbstractBackground: Normal fertilization and ongoing pregnancy can be achieved using intracytoplasmicsperm injection (ICSI), even with severely immature spermatozoa. However, the published literaturedocuments conflicting results as to the outcome of ICSI. Methods: Surgical extraction of spermatozoain 111 ICSI treatment cycles performed over five years at the Assisted Conception Unit (ACU),University College Hospital (UCH), was retrospectively evaluated to compare the outcome of ICSItreatment using either testicular or epididymal spermatozoa. Results: A higher normal fertilization rateand lower abnormal fertilization rate was observed in the epididymal spermatozoa group than in thetesticular spermatozoa group. Embryo development on day 3 after fertilization and implantation wassignificantly better in the epididymal spermatozoa group. Clinical and ongoing pregnancy rates werehigher and the spontaneous miscarriage rate lower in the epididymal spermatozoa group, but only theclinical pregnancy rate reached statistical significance. Conclusions: The origin of surgically extractedspermatozoa has an effect on the success of assisted reproduction using ICSI, and the immaturity oftesticular spermatozoa may affect fertilization, embryo development, implantation and pregnancy.Keywords: IVF, male factor, azoospermia, surgical extraction of spermatozoa, outcome
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