Skip to main content Accessibility help
×
Home
Hostname: page-component-684899dbb8-x64cq Total loading time: 0.902 Render date: 2022-05-26T15:26:42.274Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

37B - Testicular Sperm Should Be Considered for Repeated ICSI Failed Implantation Cases in Men with High DNA Damage

Against

from Section VI - Male-factor Infertility

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
Get access

Summary

Utilising ejaculated sperm with an elevated sperm DNA fragmentation (SDF) has been found to result in poor ICSI outcomes. Ejaculated sperm from the epididymis is more prone to DNA damage, due to the oxidative stress associated with epididymal transit as described by Esteves et al. [1], who found a DNA fragmentation index (DFI) of 8.3% in testicular sperm versus 40.7% in ejaculated sperm. Similar findings were reported by Greco et al. With this knowledge many clinicians are increasingly inclined to perform ICSI with testicular sperm in patients with failed implantation and high levels of DNA damage. However, no randomised controlled trials have documented the benefit of using testicular compared to ejaculated sperm [2]. In contrast, despite the lower SDF in testicular sperm, Moskovtsev et al. showed that testicular sperm have 2-3-fold higher aneuploidy rates than ejaculated samples. These results have been contested, though, in a recent study in which the rates of aneuploidy in testicular sperm were not higher than ejaculated sperm. Yet, it is important to recognise that the studies concerning aneuploidy have small samples and are inconclusive.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Esteves, SC, Sánchez-Martin, F, Sánchez-Martin, P, et al. Comparison of reproductive outcome in oligozoospermic men with high sperm DNA fragmentation undergoing intracytoplasmic sperm injection with ejaculated and testicular sperm. Fertil Steril. 2015;104(6):1398–405.CrossRefGoogle ScholarPubMed
Greco, E, Scarselli, F, Iacobelli, M, et al. Efficient treatment of infertility due to sperm DNA damage by ICSI with testicular spermatozoa. Hum Reprod. 2005;20(1):226–30.Google ScholarPubMed
Halpern, JA, Schlegel, PN. Should a couple with failed in vitro fertilization/intracytoplasmic sperm injection and increased sperm DNA fragmentation use testicular sperm for the next cycle? Eur Urol Focus. 2018;4(3):299300.CrossRefGoogle ScholarPubMed
Moskovtsev, SI, Alladin, N, Lo, KC, et al. A comparison of ejaculated and testicular spermatozoa aneuploidy rates in patients with high sperm DNA damage. Syst Biol Reprod Med. 2012;58(3):142–8.CrossRefGoogle ScholarPubMed
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(6):1469–75.e1.CrossRefGoogle ScholarPubMed
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. 2021;15(5):E272–5.Google ScholarPubMed
Awaga, HA, Bosdou, JK, Goulis, DG, et al. Testicular versus ejaculated spermatozoa for ICSI in patients without azoospermia: A systematic review. Reprod Biomed. Online, 2018;37(5):573–80.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×