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Shrivastav AM, Ali N, Singh N, Lunenfeld E, Abdulhalim I, Huleihel M. Identification of spermatogenesis in individual seminiferous tubules and testicular tissue of adult normal and busulfan-treated mice employing Raman spectroscopy and principal component analysis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 315:124232. [PMID: 38593538 DOI: 10.1016/j.saa.2024.124232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 03/05/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024]
Abstract
The present study aims to identify spermatogenesis in testicular seminiferous tubules (ST) and testicular tissue of adult normal and busulfan-treated mice utilizing PCA and Raman spectroscopy. Raman measurements were conducted on single tubules and testes samples from adult and immature mice, comparing them with those from busulfan-treated adult mice, with validation through histological examination. The analysis revealed a higher signal variability (30 %-40 % at the peaks), prompting scrutiny of individual Raman spectra as a means of spermatogenesis measurement. However, principal component analysis (PCA) demonstrated significant cluster separation between the ST of mature and immature mice. Similar investigations were performed to compare ST from normal mature mice and those from busulfan-treated (BS-treated) mature mice, revealing substantial separation along PC1 and PC2 for all comparison sets. Additionally, comparing testicular samples from mature and immature mice revealed distinct separation in PCA. The study concludes that the combined approach of PCA and Raman spectroscopy proves to be a noninvasive and potentially valuable method for identifying spermatogenesis in seminiferous tubules and testicular samples.
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Affiliation(s)
- Anand M Shrivastav
- Department of Electrooptics and Photonics Engineering, ECE School, Ilse-Kats Nanoscale Science and Technology Center, Ben Gurion University, Beer Sheva 84105, Israel; Department of Physics and Nanotechnology, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulthar, Tamil Nadu 603203, India
| | - Nagham Ali
- The Shraga Segal Dept. of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel; The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | - Neetika Singh
- Department of Electrooptics and Photonics Engineering, ECE School, Ilse-Kats Nanoscale Science and Technology Center, Ben Gurion University, Beer Sheva 84105, Israel
| | | | - Ibrahim Abdulhalim
- Department of Electrooptics and Photonics Engineering, ECE School, Ilse-Kats Nanoscale Science and Technology Center, Ben Gurion University, Beer Sheva 84105, Israel.
| | - Mahmoud Huleihel
- The Shraga Segal Dept. of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel; The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel.
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Ruan L, Gu M, Geng H, Duan Z, Yu H, Shao Z, Li K, Lv M, Tang D. Achieving an optimal pregnancy outcome through the combined utilization of micro-TESE and ICSI in cryptorchidism associated with a non-canonical splicing variant in RXFP2. J Assist Reprod Genet 2024; 41:1307-1317. [PMID: 38430325 PMCID: PMC11143137 DOI: 10.1007/s10815-024-03070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/16/2024] [Indexed: 03/03/2024] Open
Abstract
PURPOSE To identify the genetic cause of a cryptorchidism patient carrying a non-canonical splicing variant highlighted by SPCards platform in RXFP2 and to provide a comprehensive overview of RXFP2 variants with cryptorchidism correlation. METHODS We identified a homozygous non-canonical splicing variant by whole-exome sequencing and Sanger sequencing in a case with cryptorchidism and non-obstructive azoospermia (NOA). As the pathogenicity of this non-canonical splicing variant remained unclear, we initially utilized the SPCards platform to predict its pathogenicity. Subsequently, we employed a minigene splicing assay to further evaluate the influence of the identified splicing variant. Microdissection testicular sperm extraction (micro-TESE) combined with intracytoplasmic sperm injection (ICSI) was performed. PubMed and Human Genome Variant Database (HGMD) were queried to search for RXFP2 variants. RESULTS We identified a homozygous non-canonical splicing variant (NM_130806: c.1376-12A > G) in RXFP2, and confirmed this variant caused aberrant splicing of exons 15 and 16 of the RXFP2 gene: 11 bases were added in front of exon 16, leading to an abnormal transcript initiation and a frameshift. Fortunately, the patient successfully obtained his biological offspring through micro-TESE combined with ICSI. Four cryptorchidism-associated variants in RXFP2 from 90 patients with cryptorchidism were identified through a literature search in PubMed and HGMD, with different inheritance patterns. CONCLUSION This is the first cryptorchidism case carrying a novel causative non-canonical splicing RXFP2 variant. The combined approach of micro-TESE and ICSI contributed to an optimal pregnancy outcome. Our literature review demonstrated that RXFP2 variants caused cryptorchidism in a recessive inheritance pattern, rather than a dominant pattern.
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Affiliation(s)
- Lewen Ruan
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Meng Gu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hao Geng
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zongliu Duan
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Hui Yu
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhongmei Shao
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kuokuo Li
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Mingrong Lv
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China.
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Dongdong Tang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China.
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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Marinaro JA, Brant A, Kang C, Punjani N, Xie P, Zaninovic N, Palermo GD, Rosenwaks Z, Schlegel PN. Successful cryptozoospermia management with multiple semen specimen collection. Fertil Steril 2023; 120:996-1003. [PMID: 37517636 DOI: 10.1016/j.fertnstert.2023.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE To determine the prevalence of sperm suitable for intracytoplasmic sperm injection (ICSI) in fresh ejaculated semen samples provided by men scheduled for a microdissection testicular sperm extraction (mTESE) procedure. Secondary objectives included an evaluation of the effect of a short abstinence period on semen quality and ICSI outcomes for men with cryptozoospermia. DESIGN Retrospective cohort study. SETTING Academic medical center. PATIENTS All men were scheduled to undergo a mTESE procedure by a single, high-volume surgeon at an academic center from September 1, 2015, to May 1, 2021. INTERVENTION Presence of sperm suitable for ICSI in the ejaculate on the day of scheduled mTESE. MAIN OUTCOME MEASURES Prevalence of sperm suitable for ICSI in the ejaculate among previously diagnosed men with azoospermia. Secondary outcomes included changes in semen parameters, clinical pregnancy rate, and live birth rate. RESULTS Of 727 planned mTESE procedures, 69 (9.5%) were canceled because sperm suitable for ICSI were identified in a fresh ejaculated sample produced on the day of scheduled surgery (typically one day before oocyte retrieval). Overall, 50 men (50/727, 6.9%) used these rare, ejaculated sperm for ICSI. Semen samples obtained with <24 hours of abstinence were more likely to have better motility than the sample initially provided on the day of the planned mTESE. The live birth rate per ICSI attempt using these rare, ejaculated sperm was 36% (19/53). CONCLUSION Providing a fresh ejaculated semen sample on the day of mTESE allows nearly 10% of men with azoospermia to avoid surgery with satisfactory ICSI outcomes. Providing multiple ejaculated samples over a short period of time does not adversely affect sperm concentration and may enhance sperm motility in men with cryptozoospermia.
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Affiliation(s)
| | - Aaron Brant
- Department of Urology, Weill Cornell Medicine, New York, New York
| | - Caroline Kang
- Department of Urology, Weill Cornell Medicine, New York, New York; Department of Urology, Atrium Health, Charlotte, North Carolina
| | - Nahid Punjani
- Department of Urology, Weill Cornell Medicine, New York, New York; Department of Urology, Mayo Clinic, Scottsdale, Arizona
| | - Philip Xie
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Nikica Zaninovic
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Gianpiero D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Peter N Schlegel
- Department of Urology, Weill Cornell Medicine, New York, New York.
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The Trinh S, Nguyen NN, Thi Thu Le H, Thi My Pham H, Tien Trieu S, Tran NTM, Sy Ho H, Van Tran D, Van Trinh T, Trong Hoang Nguyen H, Pham Minh N, Duc Dang T, Huu Dinh V, Thi Doan H. Screening Y Chromosome Microdeletion in 1121 Men with Low Sperm Concentration and the Outcomes of Microdissection Testicular Sperm Extraction (mTESE) for Sperm Retrieval from Azoospermic Patients. Appl Clin Genet 2023; 16:155-164. [PMID: 37663123 PMCID: PMC10473397 DOI: 10.2147/tacg.s420030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
Background The Y chromosome has a specific region, namely the Azoospermia Factor (AZF) because azoospermia is typically reported in the microdeletion of the AZF region. This study aims to assess the characteristics of AZF microdeletion after screening a massive number of low sperm concentration men; and the Microdissection testicular sperm extraction (mTESE) outcomes for retrieving sperm from azoospermic patients. Materials and Methods This retrospective multiple-center study enrolled a total of 1121 men with azoospermia, cryptozoospermia, and severe oligozoospermia from December 2016 to June 2022. An extension analysis used a total of 17 STSs to detect the position-occurring microdeletion in the AZF region (AZFa, b, c, and/or d loci). Microdissection testicular sperm extraction (mTESE) was performed to retrieve sperm in azoospermic men diagnosed AZFc microdeletion. Results One hundred and fifty-three men carried AZF microdeletion were detected in the 1121 participants (13.64%). The incidences of AZF microdeletion were confined to AZF a, c, and d regions, both individual and concurrence, with the most common in the AZFc region accounting for 49.67%; There was no significant difference in clinical and paraclinical characteristics between the deleted regions, except FSH level (highest in AZFa microdeletion, p = 0.043). The AZFc region was the most common type of AZF microdeletion (49.67%), including complete microdeletion (4 patients) and gr/gr partial microdeletion (39 patients) with 50.00% and 63.63% in the success rate of mTESE, separately. Conclusion The absence of AZFa and/or AZFb regions often express the most severe phenotype - azoospermia and the increasing FSH level. The AZFc region played the most common microdeletion. Microdissection testicular sperm extraction (mTESE) was the possible therapy for sperm retrieval from the testis of azoospermia men having AZFc microdeletion.
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Affiliation(s)
- Son The Trinh
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nhat Ngoc Nguyen
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hien Thi Thu Le
- Department of Andrology, Andrology and Fertility Hospital of Hanoi, Hanoi, Vietnam
| | - Hanh Thi My Pham
- Department of Andrology, Andrology and Fertility Hospital of Hanoi, Hanoi, Vietnam
| | - Sang Tien Trieu
- Department of Biology and Genetics, Vietnam Military Medical University, Hanoi, Vietnam
| | - Ngoc Thao My Tran
- Department of Life Sciences, Biosciences Division, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Hung Sy Ho
- Department of Obstetrics and Gynecology, Hanoi Medical University, Hanoi, Vietnam
| | - Danh Van Tran
- Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Tam Van Trinh
- Department of Andrology, Andrology and Fertility Hospital of Hanoi, Hanoi, Vietnam
| | | | - Ngoc Pham Minh
- Department of Andrology, Andrology and Fertility Hospital of Hanoi, Hanoi, Vietnam
| | - Trinh Duc Dang
- Faculty of Mathematics and Computer Science, Vietnam Military Medical University, Hanoi, Vietnam
| | - Viet Huu Dinh
- Department of Andrology, Andrology and Fertility Hospital of Hanoi, Hanoi, Vietnam
| | - Hang Thi Doan
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, Vietnam
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Deng C, Mao J, Zhao L, Liu D, Lin H, Zhang Z, Yang Y, Zhang H, Hong K, Jiang H. Testicular sperm aspiration has a poor effect in predicting micro-TESE outcomes in NOA patients with AZFc deletion. Basic Clin Androl 2023; 33:28. [PMID: 37558984 PMCID: PMC10413523 DOI: 10.1186/s12610-023-00195-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/24/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Testicular sperm aspiration (TESA) is widely used in the diagnosis and management of nonobstructive azoospermia. However, its ability for predicting microdissection testicular sperm extraction in nonobstructive azoospermia (NOA) patients with AZFc deletion remains uncertain. To investigate whether TESA affected the sperm retrieval rate (SRR) in NOA patients with AZFc deletion, a retrospective analysis of the clinical data of NOA patients with AZFc deletion who underwent microdissection testicular sperm extraction (micro-TESE) was conducted. The effects of age, testicular volume, follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels, testosterone (T) levels and TESA on the SRR were analyzed in this group of patients. RESULTS A total of 181 individuals had their sperm successfully collected and underwent micro-TESE, with an SRR of 67.4%. The patients were separated into two groups based on their micro-TESE results (sperm acquisition and nonsperm acquisition), with no significant variations in age, testicular volume, FSH levels, LH levels, or T levels between the two groups. There was no significant difference in the SRR between any of the groups into which patients were classified based on reproductive hormone reference value ranges. Binary logistic regression was used to explore the absence of significant effects of age, testicular volume, FSH levels, LH levels, and T levels on sperm acquisition in patients undergoing micro-TESE. In the preoperative testicular diagnostic biopsy group, the sperm acquisition and nonsperm acquisition groups had SRRs of 90.1% and 65.1%, respectively. More significantly, there was no significant difference in the SRR between the negative preoperative testicular diagnostic biopsy group and the nonpreoperative testicular diagnostic biopsy group (65.1 vs. 63.8%, p = 0.855). CONCLUSION There is a high probability of successful sperm acquisition in the testis of men undergoing micro-TESE. In this group of patients, age, testicular volume, FSH levels, LH levels, and T levels may have little bearing on the micro-TESE outcome. In patients whose preoperative TESA revealed the absence of sperm, the probability of obtaining sperm by micro-TESE remained high (65.1%); negative TESA results appeared to not influence the SRR (63.8%) in patients undergoing micro-TESE.
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Affiliation(s)
- Chenyao Deng
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
| | - Jiaming Mao
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, 100191, China
| | - Lianming Zhao
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China
| | - Defeng Liu
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, 100191, China
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China
| | - Zhe Zhang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
| | - Yuzhuo Yang
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, 100191, China
| | - Haitao Zhang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China
| | - Kai Hong
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China.
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China.
- Department of Human Sperm Bank, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China.
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China.
- Department of Andrology, Peking University Third Hospital, Beijing, 100191, China.
- Department of Human Sperm Bank, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China.
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Hibi H, Tokoro M, Sonohara M, Ihara K, Fukunaga N, Asada Y. Cryptozoospermia: Should we use ejaculated sperm or surgically retrieved sperm for assisted reproductive technology? Reprod Med Biol 2023; 22:e12546. [PMID: 37900700 PMCID: PMC10601583 DOI: 10.1002/rmb2.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/26/2023] [Accepted: 10/01/2023] [Indexed: 10/31/2023] Open
Abstract
Purpose In cryptozoospermic subjects, it may often may be difficult to secure motile sperm for assisted reproductive technology (ART). We examined the results of ART with frozen thawed ejaculated sperm in cryptozoospermic subjects and evaluated whether sperm retrieval surgery is necessary for such patients in our clinic. Methods Between 2013 and 2021, we evaluated 197 cryptozoospermic patients. Age, endocrine panel at the time of the initial semen analysis, and anti-müllerian hormone levels at the time of the spouse's first egg retrieval were examined. Cryopreservation of ejaculated motile sperm collected essentially weekly over a 3-month period was carried out. ART data recorded was the number of egg retrieval cycles, normal fertilization rate, and clinical pregnancy rate. Results ART using frozen sperm as well as sperm ejaculated on the day of egg retrieval was possible in all cases. The normal fertilization rate was 70.4%, the clinical pregnancy rate per embryo transferred was achieved in 31.5% (870 cycles), and the live birth rate per case was 73.8%. Conclusions Intracytoplasmic sperm injection (ICSI) was possible without sperm retrieval surgery in cryptozoospermia, resulting in 73.8% of live births per patient. Sperm identification, sperm processing, and ICSI technique are especially important in cryptozoospermia. Sperm retrieval surgery can be avoided in cryptozoospermic patients.
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Affiliation(s)
- Hastuki Hibi
- Department of UrologyKyoritsu General HospitalNagoyaJapan
- Asada Ladies ClinicNagoyaJapan
| | - Mikiko Tokoro
- Asada Ladies ClinicNagoyaJapan
- Asada Institute for Reproductive MedicineNagoyaJapan
| | | | - Kazuho Ihara
- Asada Ladies ClinicNagoyaJapan
- Asada Institute for Reproductive MedicineNagoyaJapan
| | - Noritaka Fukunaga
- Asada Ladies ClinicNagoyaJapan
- Asada Institute for Reproductive MedicineNagoyaJapan
| | - Yoshimasa Asada
- Asada Ladies ClinicNagoyaJapan
- Asada Institute for Reproductive MedicineNagoyaJapan
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Liu H, Luo Z, Chen J, Zheng H, Zeng Q. Treatment progress of cryptozoospermia with Western Medicine and traditional Chinese medicine: A literature review. Health Sci Rep 2022; 6:e1019. [PMID: 36582629 PMCID: PMC9793827 DOI: 10.1002/hsr2.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Background and Aims Cryptozoospermia is an extreme oligozoospermia with an unsatisfactory treatment effect, with an incidence rate of approximately 8.73% in male infertility, whose effective solution has become the call of the times. Western Medicine has achieved certain effects through drugs, surgery, and assisted reproductive therapy, but this is still not ideal. Traditional Chinese medicine (TCM) has made many achievements in other disciplines; however, there is still a lack of evidence-based medical evidence to improve sperm production. Methods The relevant literatures from the China National Knowledge Internet (CNKI) and PubMed in the past 10 years were collected in this article, of which the mechanisms, advantages, or current controversies of various treatment methods of Western Medicine and TCM were analyzed, to find new treatment methods and research directions. Results With the development of modern science and technology, medical treatments for cryptozoospermia have become increasingly abundant; however, there is still no universally recognized unified and effective guiding plan. Although TCM has not been fully verified by evidence-based medicine, most TCM combined with Western Medicine can achieve unexpected results. Conclusion The combination of TCM and Western Medicine may become a bane for cryptozoospermia and bring good news to infertile men worldwide.
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Affiliation(s)
- Huang Liu
- The First School of Clinical MedicineNanjing University of Chinese MedicineNanjingChina,NHC Key Laboratory of Male Reproduction and Genetics, Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital)Human Sperm Bank of Guangdong ProvinceGuangzhouChina
| | - Zefang Luo
- NHC Key Laboratory of Male Reproduction and Genetics, Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital)Human Sperm Bank of Guangdong ProvinceGuangzhouChina
| | - Jinghua Chen
- Reproductive Medical Centre of Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Houbin Zheng
- NHC Key Laboratory of Male Reproduction and Genetics, Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital)Human Sperm Bank of Guangdong ProvinceGuangzhouChina
| | - Qingqi Zeng
- The First School of Clinical MedicineNanjing University of Chinese MedicineNanjingChina,Department of Integrated Chinese and Western MedicineJiangsu Health Vocational CollegeNanjingChina
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Alkandari MH, Moryousef J, Zini A. Does testicular sperm retrieval adversely impact spermatogenesis over the long-term? Andrologia 2022; 54:e14401. [PMID: 35243681 DOI: 10.1111/and.14401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022] Open
Abstract
Testicular sperm retrieval (TSR) techniques are valuable in the context of severe idiopathic male factor infertility; however, there are few studies in the literature examining the long-term impact of TSR on testicular function. The objective was to determine whether testicular sperm aspiration (TESA) or microdissection testicular sperm extraction (micro-TESE) worsens the pre-existing spermatogenesis deficiency in men with either cryptozoospermia or severe oligozoospermia. The study population consisted of 145 men with either cryptozoospermia or severe oligozoospermia that underwent TESA or micro-TESE and had long-term post-operative semen analyses (SA). Patients with SA prior to and following TSR were included (n = 24). Amongst them, 16 men underwent TESA and 8 underwent micro-TESE. The follow-up SA was obtained at a mean of 3.0 ± 2.0 years following TSR (range: 0.3-8.3 years) amongst all participants. The post-operative semen parameters in the TESA group were similar to the pre-intervention parameters (p > 0.1). Similarly, the micro-TESE cohort did not demonstrate significant alterations in semen parameters post-intervention (p > 0.05). None of the men in the study became azoospermic following the TSR. Our study indicates TESA or micro-TESE do not appear to worsen the pre-existing spermatogenesis deficiencies in cryptozoospermic and oligozoospermic men over a long-term period. Larger studies are required to corroborate these findings.
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Affiliation(s)
- Mohammad H Alkandari
- Division of Urology, Department of Surgery, Mubarrak Al-Kabeer Hospital, Jabriya, Kuwait
| | | | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,OVO Fertility Clinic, Montreal, QC, Canada
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Sharma RK, Gupta S, Agarwal A, Finelli R, Kuroda S, Saleh R, Boitrelle F, Kavoussi P, Gül M, Tadros N, Ko E, Farkouh A, Henkel R, Arafa M, Rambhatla A, Shah R. Role of Cytocentrifugation Combined with Nuclear Fast Picroindigocarmine Staining in Detecting Cryptozoospermia in Men Diagnosed with Azoospermia. World J Mens Health 2022; 40:627-635. [PMID: 35118836 PMCID: PMC9482851 DOI: 10.5534/wjmh.210210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/13/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose Azoospermia is defined as the absence of spermatozoa in the pellet of a centrifuged semen sample. In fact, when a basic semen analysis fails to detect sperm in the ejaculate, there is still the possibility of detecting rare sperm after centrifugation of the sample and examination of the pellet. In this study, we assessed the role of Cytospin centrifugation in combination with the nuclear fast picroindigocarmine (NF-PIC) staining in identifying sperm in azoospermic samples. Materials and Methods Semen samples of 251 men diagnosed as having azoospermia after standard examination were further analyzed by Cytospin centrifugation in combination with NF-PIC staining. Results Sperm were detected in 60 men (23.9%), thus changing their diagnosis to cryptozoospermia. Conclusions By identifying sperm in the semen of men who were thought to have total azoospermia, the Cytospin NF-PIC test can alter the diagnosis and further treatment of these men.
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Affiliation(s)
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | | | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Ala’a Farkouh
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland, OH, USA
- LogixX Pharma Ltd., Theale, Berkshire, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Amarnath Rambhatla
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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10
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Alkandari MH, Bouhadana D, Zini A. Is a contralateral testicular exploration required at microdissection testicular sperm extraction for men with nonobstructive azoospermia, cryptozoospermia or severe oligozoospermia? Andrologia 2021; 53:e14208. [PMID: 34352113 DOI: 10.1111/and.14208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/20/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Men with nonobstructive azoospermia (NOA), cryptozoospermia and severe oligozoospermia are candidates for microdissection testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI). We sought to evaluate micro-TESE outcomes and the need for bilateral testicular exploration in the three groups of men. METHODS We conducted a retrospective study of 233 consecutive micro-TESEs in men with nonobstructive azoospermia (n = 173), cryptozoospermia (n = 43) and severe oligozoospermia (n = 17). The decision to terminate the micro-TESE after a unilateral or bilateral testicular exploration was determined at the time of surgery and was based on the presence or absence of mature spermatozoa in the harvested micro-biopsies. Final assessment of sperm recovery, on the day of ICSI, was reported as successful (available spermatozoon for ICSI) or unsuccessful (no spermatozoon for ICSI). RESULTS Unilateral testicular exploration resulted in successful sperm retrieval in 43% (75/173), 79% (34/43) and 100% (17/17) of men with NOA, cryptozoospermia and severe oligozoospermia respectively. Therefore, 57%, 21% and none of the men with NOA, cryptozoospermia and severe oligozoospermia, respectively, required a bilateral micro-TESE. Overall, micro-TESE resulted in successful sperm retrieval in 52% (90/173), 91% (39/43) and 100% (17/17) of men with NOA, cryptozoospermia and severe oligozoospermia respectively. CONCLUSION Our data indicate that men with severe oligozoospermia are unlikely to require a bilateral testicular exploration at micro-TESE. Moreover, most cryptozoospermic men will have a successful sperm retrieval by micro-TESE with the majority of these patients requiring a unilateral exploration. In contrast, over 50% of the men with nonobstructive azoospermia will require a bilateral micro-TESE.
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Affiliation(s)
- Mohammad H Alkandari
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - David Bouhadana
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,OVO Fertility Clinic, Montreal, QC, Canada
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11
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Alkandari MH, Moryousef J, Phillips S, Zini A. Testicular Sperm Aspiration (TESA) or Microdissection Testicular Sperm Extraction (Micro-tese): Which Approach is better in Men with Cryptozoospermia and Severe Oligozoospermia? Urology 2021; 154:164-169. [PMID: 33991573 DOI: 10.1016/j.urology.2021.04.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/07/2021] [Accepted: 04/28/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate and compare sperm retrieval outcomes by testicular sperm aspiration (TESA) and micro-dissection testicular sperm extraction (micro-TESE) in non-azoospermic men. METHODS We conducted a retrospective study of 145 consecutive testicular sperm retrievals in men with cryptozoospermia (n = 56) or severe oligozoospermia (n = 84). The decision to perform a TESA or a micro-TESE was made after thorough discussion of the pros and cons of these procedures with the couple. Final assessment of sperm recovery, on the day of ICSI, was reported either as successful (available sperm for ICSI) or unsuccessful (no sperm for ICSI). RESULTS Mean sperm concentration, sperm motility, testicular volume and serum FSH level of men undergoing TESA were not significantly different from those of men undergoing micro-TESE. In men with severe oligozoospermia (<5 million/ml), sperm recovery was successful in 95% (18/19) of those who underwent micro-TESE and in 92% (60/65) of those who underwent TESA (P > 0.05). In men with cryptozoospermia, sperm recovery was successful in 88% (42/48) of men who underwent micro-TESE and 25% (2/8) of men who underwent TESA (P < .001). CONCLUSIONS These data indicate that in men with severe oligozoospermia, TESA and micro-TESE are equally successful sperm retrieval techniques. However, in men with cryptozoospermia, sperm retrieval rates are significantly higher with micro-TESE than TESA.
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Affiliation(s)
| | | | | | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, Canada; OVO Fertility Clinic, Montreal, Canada.
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12
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Zhang Z, Jing J, Luo L, Li L, Zhang H, Xi Q, Liu R. ICSI outcomes of fresh or cryopreserved spermatozoa from micro-TESE in patients with nonobstructive azoospermia: CONSORT. Medicine (Baltimore) 2021; 100:e25021. [PMID: 33761658 PMCID: PMC9282029 DOI: 10.1097/md.0000000000025021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/11/2021] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to evaluate intracytoplasmic sperm injection (ICSI) outcomes of fresh and cryopreserved sperm via microdissection testicular sperm extraction (micro-TESE) in patients with nonobstructive azoospermia (NOA).From March 2016 to February 2020, a total of 244 men with NOA underwent micro-TESE at the Center for Reproductive Medicine, First Hospital of Jilin University, P. R. China. These cases included 40 patients who underwent 40 ICSI cycles with fresh spermatozoa from micro-TESE (Group A) and 30 patients who underwent 30 ICSI cycles with cryopreserved spermatozoa from micro-TESE (Group B). The characteristics, embryonic development, and ICSI outcomes of patients were compared between groups A and B.Our sperm retrieval rate (SRR) by micro-TESE in patients with NOA was 35.25%. No statistical differences in the patient characteristics and fertilization or quality embryo rates were observed between Groups A and B. Higher miscarriage rates and lower live births were observed in Group B than in Group A (both P < .05).Fresh testicular spermatozoa seem to produce better ICSI outcomes than cryopreserved testicular spermatozoa from patients with NOA in the micro-TESE-ICSI cycle.
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Affiliation(s)
- Zhihong Zhang
- Centre for Reproductive Medicine, Centre for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
| | - Jili Jing
- Centre for Reproductive Medicine, Centre for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
| | - Lili Luo
- Centre for Reproductive Medicine, Centre for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
| | - Leilei Li
- Centre for Reproductive Medicine, Centre for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
| | - Hongyang Zhang
- Centre for Reproductive Medicine, Centre for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
| | - Qi Xi
- Centre for Reproductive Medicine, Centre for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
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13
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Alharbi M, Almarzouq A, Zini A. Sperm retrieval and intracytoplasmic sperm injection outcomes with testicular sperm aspiration in men with severe oligozoospermia and cryptozoospermia. Can Urol Assoc J 2020; 15:E272-E275. [PMID: 33119503 DOI: 10.5489/cuaj.6798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Several studies addressed the role of testicular sperm aspiration with intracytoplasmic sperm injection (ICSI) in azoospermic men, but few have included non-azoospermic men. The aim of this study was to evaluate testicular sperm aspiration (TESA) sperm retrieval rates and ICSI outcomes in men with severe oligozoospermia. METHODS Data were collected retrospectively from 88 consecutive, non-azoospermic, infertile men with idiopathic severe oligozoospermia who underwent TESA between January 2011 and January 2018. Patients were categorized into four groups according to sperm concentration: <5 and >1 million/ml (group 1), <1 and > 0.1 million/ml (group 2), <0.1 million/ml (group 3), and cryptozoospermia (group 4). RESULTS Mean male age was 37±7 years and the mean female age was 33±4 years. Sperm was recovered successfully in 90% (79/88) of the men overall and in 100% (30/30) of the men in group 1, 97% (29/30) of the men in group 2, 88% (15/17) of the men in group 3, and 45% (5/11) of the men in group 4. Most (65%, 57/88) of the couples had an embryo transfer (ET). The overall clinical pregnancy rate per ET was 46% (26/57). The clinical pregnancy rates (per ET) were 43% (9/21) in group 1, 65% (13/20) in group 2, 36% (4/11) in group 3, and 0% (0/5) in group 4. CONCLUSIONS Our data indicate TESA allows for high sperm retrieval rates and acceptable ICSI pregnancy rates in men with severe oligozoospermia. However, in our experience, TESA sperm retrieval rates and ICSI outcomes are poor in cryptozoospermic men.
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Affiliation(s)
- Mohannad Alharbi
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,Department of Surgery, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ahmad Almarzouq
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,OVO Fertility Clinic, Montreal, QC, Canada
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14
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Almajed W, Alharbi M, Zini A. Use of mini-incision microdissection testicular sperm extraction in men with cryptozoospermia and non-obstructive azoospermia. Andrology 2020; 8:1136-1142. [PMID: 32279452 DOI: 10.1111/andr.12795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 03/08/2020] [Accepted: 04/01/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Microdissection testicular sperm extraction (micro-TESE) is a procedure commonly utilized to harvest spermatozoa in severe male factor infertility. We have developed a technique involving a mini tunica albuginea incision with superficial tissue dissection (mini-incision micro-TESE). The modification is designed to reduce potential tissue injury, and we studied its effectiveness to harvest spermatozoa in men with cryptozoospermia and non-obstructive azoospermia. MATERIALS AND METHODS We performed a retrospective analysis of 103 infertile men with NOA and cryptozoospermia who underwent a mini-incision micro-TESE between March 2015 and August 2018 at the OVO fertility clinic. We consider the mini-incision micro-TESE procedure successful when at least five spermatozoa are identified in the micro-biopsies obtained from the superficial tissue exposed by the 1-cm mini-incision. If no spermatozoa are identified through the mini-incision, we can easily extend the incision to the standard micro-TESE. RESULTS The mini-incision procedure allowed for successful recovery of spermatozoa (intra-operative recovery of ≥ 5 spermatozoa) in 58% of men with cryptozoospermia and 25.6% of men with NOA. Overall, a successful sperm retrieval (with conversion to conventional micro-TESE if mini-incision was not successful) was achieved in 89% of men with cryptozoospermia and 48% of men with NOA. A successful mini-incision micro-TESE was associated with a significantly lower number of biopsies than conventional micro-TESE (8.8 vs 24.2, P < .0001). Moreover, in men undergoing a redo micro-TESE after a previously successful micro-TESE, 64% (9/14) had spermatozoa found and 21% (3/14) of these men only required a mini-incision micro-TESE. CONCLUSION Our data suggest that mini-incision micro-TESE is a useful approach in men undergoing micro-TESE, allowing for a shorter incision and a high sperm retrieval rate in men with cryptozoospermia. Furthermore, the findings of our study offer insight into the distribution of spermatogenesis in men with cryptozoospermia and NOA.
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Affiliation(s)
- Wael Almajed
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Mohannad Alharbi
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,Department of Urology, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,OVO Fertility Clinic, Montreal, QC, Canada
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15
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Babakhanzadeh E, Nazari M, Ghasemifar S, Khodadadian A. Some of the Factors Involved in Male Infertility: A Prospective Review. Int J Gen Med 2020; 13:29-41. [PMID: 32104049 PMCID: PMC7008178 DOI: 10.2147/ijgm.s241099] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/23/2020] [Indexed: 01/04/2023] Open
Abstract
Infertility is defined as the inability of couples to have a baby after one year of regular unprotected intercourse, affecting 10 to 15% of couples. According to the latest WHO statistics, approximately 50-80 million people worldwide sufer from infertility, and male factors are responsible for approximately 20-30% of all infertility cases. The diagnosis of infertility in men is mainly based on semen analysis. The main parameters of semen include: concentration, appearance and motility of sperm. Causes of infertility in men include a variety of things including hormonal disorders, physical problems, lifestyle problems, psychological issues, sex problems, chromosomal abnormalities and single-gene defects. Despite numerous efforts by researchers to identify the underlying causes of male infertility, about 70% of cases remain unknown. These statistics show a lack of understanding of the mechanisms involved in male infertility. This article focuses on the histology of testicular tissue samples, the male reproductive structure, factors affecting male infertility, strategies available to find genes involved in infertility, existing therapeutic methods for male infertility, and sperm recovery in infertile men.
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Affiliation(s)
- Emad Babakhanzadeh
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Nazari
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sina Ghasemifar
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Khodadadian
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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16
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Lin PY, Huang CC, Chen HH, Huang BX, Lee MS. Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy. PLoS One 2019; 14:e0224919. [PMID: 31738801 PMCID: PMC6860430 DOI: 10.1371/journal.pone.0224919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 10/24/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose Unexpected sperm retrieval failure on the day of oocyte retrieval is not common but frequently happened in patients with severe oligospermia or non-obstructive azoospermia(NOA). Oocyte cryopreservation is a common strategy after failed collection of sperm when concurrent ovarian stimulation is underwent. However, the use of oocyte vitrification in such male-infertility cases remains unclear. Objective To investigate the outcomes of emergent oocyte cryopreservation after failed sperm retrieval from severe oligospermic or non-obstructive azoospermic (NOA) patients on oocyte retrieval day. Methods Design: Retrospective cohort study Setting: Academic fertility center at Lee Women's Hospital, Taiwan, between March 2015 and August 2017. Patients: For 203 couples with NOA(n = 200) or severe oligospermia(n = 3), testicular spermatozoa (n = 67 cycles) or frozen donor sperm (n = 209 cycles) were injected into fresh or frozen-thawed oocytes via 276 intracytoplasmic sperm injection (ICSI) cycles. Main Outcome Measures: Clinical pregnancy and live-birth rates (LBRs). Results In the 67 cycles involving the use of fresh testicular spermatozoa, no significant differences were observed between fresh and warmed oocytes with respect to the fertilization rates (69.2% vs. 74.1%; p = 0.27), number of Day-3 embryos (8.6±4.4 vs. 6.4±3.4; p = 0.08), number of good-quality Day-3 embryos (4.5±3.9vs. 4.7±3.0; p = 0.45), implantation rates (29.1% vs. 17.8%; p = 0.21), clinical pregnancy rates (36.4% vs. 26.8.0%; p = 0.81), live birth rates (36.4% vs. 14.3%; p = 0.46), or perinatal outcomes. In the 209 cycles involving the use of frozen donor sperm, no significant differences were seen between the two groups, except that the mean birth weights were significantly lower with fresh oocyte pregnancies than with warmed oocytes (2952±196 gm vs 2643±700 gm; p = 0.006). Conclusions Emergent oocyte cryopreservation is a feasible strategy to manage unexpected sperm retrieval failure from severe oligospermic or NOA patients on the oocyte retrieval day. There is no detrimental effect on the live birth rate when testicular spermatozoa or frozen donor sperm are injected into the thawed oocytes compared with fresh oocytes.
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Affiliation(s)
- Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Bo-Xuan Huang
- Department of Urology, Puli Christian Hospital, Nantou, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail:
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17
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Chen C, Wang YC, Wang YM, Qin C, Song NH. Microdissection testicular extraction for a patient with transverse testicular ectopia and testicular fusion. Asian J Androl 2019; 20:306-307. [PMID: 28869220 PMCID: PMC5952488 DOI: 10.4103/aja.aja_33_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Chen Chen
- Department of Urology, State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Yi-Chun Wang
- Department of Urology, State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Ya-Min Wang
- Department of Urology, State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Chao Qin
- Department of Urology, State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Ning-Hong Song
- Department of Urology, State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
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18
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Yu Y, Wang R, Xi Q, Zhang H, Jiang Y, Li L, Liu R, Zhang X. Effect of paternal age on intracytoplasmic sperm injection outcomes in cryptozoospermic men: Ejaculated or testicular sperm? Medicine (Baltimore) 2019; 98:e16209. [PMID: 31261571 PMCID: PMC6617486 DOI: 10.1097/md.0000000000016209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
It is not clear whether age has any influence on the outcomes for sperm used for assisted reproductive technology in cryptozoospermic men. We evaluated intracytoplasmic sperm injection (ICSI) outcomes using ejaculated or testicular sperm in men with cryptozoospermia from different paternal age ranges.We conducted a retrospective observational study of 35 men with cryptozoospermia who underwent ICSI from 2010 to 2018. They were classified into 2 groups based on male age, namely < 35 years and ≥ 35 years. Each group was further divided into 2 subgroups according to the origin of sperm (ejaculated or testicular).In the <35 years group, the normal fertilization and high-quality embryo rates for ejaculated sperm were significantly higher than with testicular sperm (74.7% vs. 62.4%, P = .02; 50.5% vs. 36.6%, P = .03, respectively). However, in the ≥35 years group, the high-quality embryo and clinical pregnancy rates were significantly lower in the ejaculated sperm subgroup than in the testicular sperm subgroup (26.2% vs. 63%, P = .002; 12.5% vs. 71.4%, P = .04, respectively).This study indicates that ICSI should be performed as soon as possible for men with cryptozoospermia. When the paternal age ≥35 years, testicular sperm should be used for ICSI, as this offers better high-quality embryo and clinical pregnancy rates.
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19
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Miller N, Biron-Shental T, Pasternak Y, Belenky M, Shefi S, Itsykson P, Berkovitz A. Fertility outcomes after extended searches for ejaculated spermatozoa in men with virtual azoospermia. Fertil Steril 2017; 107:1305-1311. [PMID: 28483501 DOI: 10.1016/j.fertnstert.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/06/2017] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the fertility outcomes of extended searches for ejaculated spermatozoa in men with virtual azoospermia. DESIGN A retrospective cohort of 242 couples whose male partner suffered from nonobstructive azoospermia and who were treated with the use of intracytoplasmic sperm injection (ICSI). SETTING Not applicable. PATIENT(S) One hundred forty patients were referred to an extended search in the ejaculate and 102 patients were referred to microsurgical testicular sperm extraction (microTESE). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Rates of sperm retrieval, fertilization, and pregnancy, take-home baby rate, and missed abortion rate were analyzed and compared. RESULT(S) In the ejaculated spermatozoa group, motile spermatozoa were retrieved in 91 cases (65%) and on oocyte pick-up day in 71 cases (78%), compared with 70 cases (68%) in the microTESE group, with a similar incidence of sperm retrieval between groups. No significant difference was found between groups regarding mean number of embryo transfer and fertilization and pregnancy rates. There was no significant difference between groups regarding take-home baby rate. A significantly higher first-trimester missed abortion rate was found in the ejaculated sperm group (n = 14; 52%) compared with the microTESE group (n = 3; 8.6%). CONCLUSION(S) Conducting an extended spermatozoa search in the ejaculate of men with virtual azoospermia can provide pregnancy rates similar to those obtained with the use of microTESE, with a higher rate of spontaneous abortions in the ejaculate group.
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Affiliation(s)
- Netanella Miller
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel.
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel; Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Pasternak
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel
| | | | - Shai Shefi
- Assuta Medical Center, Tel Aviv, Israel; Advanced Andrology Clinic, Tel Aviv, Israel
| | | | - Arie Berkovitz
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel; Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Assuta Medical Center, Tel Aviv, Israel
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20
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Affiliation(s)
- Rachel Busuttil Leaver
- Lecturer Practitioner, Urological Care, University College London Hospital and London South Bank University
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21
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Ketabchi AA. Intracytoplasmic Sperm Injection Outcomes with Freshly Ejaculated Sperms and Testicular or Epididymal Sperm Extraction in Patients with Idiopathic Cryptozoospermia. Nephrourol Mon 2016; 8:e41375. [PMID: 27896242 PMCID: PMC5120410 DOI: 10.5812/numonthly.41375] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 10/08/2016] [Indexed: 01/23/2023] Open
Abstract
Background Cryptozoospermia (CO) is a situation in which spermatozoa cannot be observed in a fresh semen sample unless an extended centrifugation and microscopic search are performed. CO patients are suggested to use only intracytoplasmic sperm injection (ICSI) as infertility treatment. But still there is debate about the choice of sperm source in cryptozoospermic men candidate for ICSI. Objectives This study was conducted to evaluate fertility outcomes in men with idiopathic cryptozoospermia who were treated using ICSI with freshly ejaculated sperm and testis sperm extraction (TESE) or percutaneous epididymal sperm aspiration (PESA). Methods In this prospective cohort study carried out in an academic institution, 83 out of 92 couples with cryptozoospermia undergoing their first ICSI cycle were recruited. These patients were randomly allocated to two groups: group one (n = 42) who produced freshly ejaculated sperm and, group two (n = 41) who produced a sample by TESE or PESA. The groups were analyzed and compared in terms of fertilization rate, cleavage rate, embryo quality, implantation rate, and clinical pregnancy rate. Results There was a significant difference in fertilization rate, embryo quality, implantation rate, and pregnancy rates between the group of surgically extracted sperm and those of naturally ejaculated sperm using conventional ICSI (P < 0.05). Conclusions Sperm quality extracted by percutaneous PESA and TESE procedures increases fertility outcomes compared to naturally ejaculated sperm in men with idiopathic CO. More specifically, embryo quality, which is most relevant to fertility outcome, improved when surgically extracted sperm was used for ICSI.
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Affiliation(s)
- Ali Asghar Ketabchi
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Corresponding author: Ali Asghar Ketabchi, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran. Tel: +98-3432114348, Fax: +98-3432239188, E-mail:
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22
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Abhyankar N, Kathrins M, Niederberger C. Use of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with cryptozoospermia: a meta-analysis. Fertil Steril 2016; 105:1469-1475.e1. [PMID: 26930617 DOI: 10.1016/j.fertnstert.2016.02.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To examine outcomes of intracytoplasmic sperm injection (ICSI) using testicular versus ejaculated sperm among men with cryptozoospermia. DESIGN Meta-analysis. SETTING Not applicable. PATIENT(S) Men with cryptozoospermia undergoing consecutive ICSI cycles using ejaculated or testicular sperm. INTERVENTION(S) A systematic search was performed using PubMed (inception to August 2015). Inclusion criteria were studies comparing ICSI outcomes among men with cryptozoospermia using ejaculated and testicular sperm. MAIN OUTCOME MEASURE(S) Primary outcomes included ICSI fertilization or pregnancy rates (PRs). Secondary analysis included number of retrieved oocytes, maternal and paternal ages. Meta-analysis of weighted data using a random effects model was performed. Results are reported as relative risk or weighted mean differences (WMD) with 95% confidence intervals (CI). RESULT(S) Five cohort studies were included, encompassing 272 ICSI cycles and 4,596 injected oocytes. There were no differences in ICSI PRs (relative risk [RR] 0.53, 95% CI 0.19-1.42, I(2) = 67%) or fertilization rates (RR 0.91, 95% CI 0.78-1.06, I(2) = 73%) between testicular and ejaculated sperm groups. There was a significant trend toward increasing maternal age (WMD 1.69 years, 95% CI -2.71 to -0.66) and paternal age (WMD 2.61 years, 95% CI -4.73 to -0.48) with testicular sperm. There was no difference between numbers of oocytes retrieved (WMD 0.95, 95% CI -0.15 to 2.05). Post-hoc power analysis revealed pβ <20% for PR analysis and pβ <10% for fertilization rate analysis. CONCLUSION(S) The existing literature does not support a recommendation for men with cryptozoospermia to use testicular sperm in preference over ejaculated sperm for ICSI.
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Affiliation(s)
- Nikita Abhyankar
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois.
| | - Martin Kathrins
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Craig Niederberger
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
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23
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Alrabeeah K, Witmer J, Ruiz S, AlMalki A, Phillips S, Zini A. Mini-incision microdissection testicular sperm extraction: a useful technique for men with cryptozoospermia. Andrology 2016; 4:284-9. [DOI: 10.1111/andr.12152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 11/05/2015] [Accepted: 11/30/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - J. Witmer
- Ovo Fertility Clinic; Montreal QC Canada
| | - S. Ruiz
- Ovo Fertility Clinic; Montreal QC Canada
| | | | | | - A. Zini
- McGill University; Montreal QC Canada
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24
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Montagut M, Gatimel N, Bourdet-Loubère S, Daudin M, Bujan L, Mieusset R, Isus F, Parinaud J, Leandri R. Sperm freezing to address the risk of azoospermia on the day of ICSI. Hum Reprod 2015; 30:2486-92. [DOI: 10.1093/humrep/dev234] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/24/2015] [Indexed: 11/12/2022] Open
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25
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Nordhoff V, Fricke RK, Schüring AN, Zitzmann M, Kliesch S. Treatment strategies for severe oligoasthenoteratozoospermia (OAT) (<0.1 million/mL) patients. Andrology 2015; 3:856-63. [PMID: 26266459 DOI: 10.1111/andr.12077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/27/2015] [Accepted: 06/20/2015] [Indexed: 12/23/2022]
Abstract
Intracytoplasmic sperm injection (ICSI) using spermatozoa from patients with severe oligoasthenoteratozoospermia is still a challenge. Although spermatozoa are available, lower fertilisation rates as well as compromised pregnancy rates are observed after ICSI. We aimed at identifying respective parameters in the pre-values of ejaculate samples used for couple counselling. The clinical pre-values of 121 patients and their corresponding 228 ICSI cycles performed between 2002 and 2010 were retrospectively analysed. Patients were divided into three groups: (i) group 1 (G1, n = 51) where all patients showed at least once <0.1 million/mL and ICSI was performed using ejaculate alone; (ii) group 2 (G2, n = 14) patients had once <0.1 Mill/mL or azoospermia and a testicular biopsy before start of ICSI; (iii) group 3 (G3, n = 56) patients were azoospermic and directed immediately to testicular sperm extraction (TESE). The pre-values of G2 differed significantly from G1 in terms of volume and motility. Lutenizing hormone (LH) and follicle-stimulating hormone (FSH) values were equal in G1 and G2, but showed significant differences in comparison to G3. Testis volume was significantly higher in G3. In the corresponding ICSI cycles, the percentage of cancelled embryo transfers was highest in G3. We did not find any correlations of hormonal markers or sperm pre-values with the success rates of ICSI. In our patient cohort, spermatozoa retrieved either from ejaculate or testicular biopsies have nearly identical chances in achieving pregnancies. Patients in need of TESE before ICSI have significantly lower sperm counts. However, it is not possible to calculate threshold values as indicator for TESE.
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Affiliation(s)
- V Nordhoff
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
| | - R K Fricke
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
| | - A N Schüring
- UKM Kinderwunschzentrum, Department of Gynaecology and Obstetrics, University Hospital of Münster, Münster, Germany
| | - M Zitzmann
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
| | - S Kliesch
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
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