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Intracytoplasmic sperm injection (ICSI) in extreme cases of male infertility

PloS one, 2014-12, Vol.9 (12), p.e113671-e113671 [Peer Reviewed Journal]

COPYRIGHT 2014 Public Library of Science ;COPYRIGHT 2014 Public Library of Science ;2014 Palermo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2014 Palermo et al 2014 Palermo et al ;ISSN: 1932-6203 ;EISSN: 1932-6203 ;DOI: 10.1371/journal.pone.0113671 ;PMID: 25437298

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Title:
Intracytoplasmic sperm injection (ICSI) in extreme cases of male infertility
Author: Palermo, Gianpiero D ; Neri, Queenie V ; Schlegel, Peter N ; Rosenwaks, Zev
Schlatt, Stefan
Subjects: Adult ; Biology and Life Sciences ; Cohen, Claudia ; Cohort analysis ; Consent ; Deoxyribonucleic acid ; DNA ; Embryonic development ; Female ; Fertilization ; Human rights ; Humans ; Implantation ; Infertility ; Infertility, Male - genetics ; Infertility, Male - physiopathology ; Infertility, Male - therapy ; Injection ; Male ; Medicine and Health Sciences ; Middle Aged ; Motility ; Offspring ; Oocytes ; Ovulation Induction ; Patients ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Reproductive health ; Retrospective Studies ; Searching ; Semen ; Semen Analysis ; Sperm ; Sperm Injections, Intracytoplasmic - methods ; Spermatogenesis ; Spermatozoa ; Spermatozoa - physiology ; Testis - physiopathology ; Treatment Outcome ; Tubules
Is Part Of: PloS one, 2014-12, Vol.9 (12), p.e113671-e113671
Description: Severely compromised spermatogenesis typical of men with virtual azoospermia or non-obstructive azoospermia requires an extreme search for spermatozoa. Our goal was to evaluate the usefulness of a meticulous search carried out in ejaculated or surgically retrieved specimens in achieving pre- and post-implantation embryo development. In a retrospective cohort study carried out in an academic institution, intracytoplasmic sperm injection (ICSI) outcomes were reviewed as a function of length of microscopic sperm search in ejaculated and surgically retrieved specimens. Couples whose male partner presented with either virtual or non-obstructive azoospermia were treated by ICSI and categorized according to the time spent in identifying and retrieving enough spermatozoa to inject all the oocyte cohort. Semen parameter, fertilization, pregnancies, deliveries, and child welfare in relation to increasing search time were analyzed and compared. The maternal and paternal ages were comparable in both ejaculated and testicular sperm extraction (TESE) groups along with the oocytes retrieved. The fertilization rates for both ejaculated and TESE progressively decreased with increasing time (P<0.0001). Clinical pregnancies in the ejaculated cohort remained satifactory. In the TESE cohort, there was a decrease in pregnancy rate with increasing time, from 44% to 23%. In a limited number of cases, offspring health was evaluated in both semen sources and appeared reassuring. An extensive and at time exhaustive sperm quest yields kinetically and morphologically impaired spermatozoa without apparent impact on embryo developmental competence. Retrieval of spermatozoa from the seminiferous tubules provided more consistent fertilization and pregnancy outcomes than those retrieved from the ejaculate. A trend indicated that pregnancy rate decreased as search time increased in the TESE group. The utilization of the scarce and unselected spermatozoa did not obviously impair embryo development or cause post-implantation errors.
Publisher: United States: Public Library of Science
Language: English
Identifier: ISSN: 1932-6203
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0113671
PMID: 25437298
Source: PLoS (Open access)
Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
Directory of Open Access Journals
PubMed Central（OA）
ProQuest Central

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Intracytoplasmic sperm injection (ICSI) in extreme cases of male infertility

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