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A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia.

Publication ,  Journal Article
Morin, SJ; Hanson, BM; Juneau, CR; Neal, SA; Landis, JN; Scott, RT; Hotaling, JM
Published in: Asian J Androl
2020

This is a retrospective cohort study comparing blastocyst transfer outcomes following intracytoplasmic sperm injection utilizing epididymal versus testicular sperm for men with obstructive azoospermia. All cases at a single center between 2012 and 2016 were included. Operative approach was selected at the surgeon's discretion and included microepididymal sperm aspiration or testicular sperm extraction. Blastocyst culture was exclusively utilized prior to transfer. The primary outcome was live birth rate. Secondary outcomes included fertilization rate, blastulation rate, euploidy rate, and implantation rate. A mixed effects model was performed. Seventy-six microepididymal sperm aspiration cases and 93 testicular sperm extraction cases were analyzed. The live birth rate was equivalent (48.6% vs 50.5%, P = 0.77). However, on mixed effects model, epididymal sperm resulted in a greater likelihood of fertilization (adjusted OR: 1.37, 95% CI: 1.05-1.81, P = 0.02) and produced a higher blastulation rate (adjusted OR: 1.41, 95% CI: 1.1-1.85, P = 0.01). As a result, the epididymal sperm group had more supernumerary blastocysts available (4.3 vs 3, P < 0.05). The euploidy rate was no different. Pregnancy rates were no different through the first transfer cycle. However, intracytoplasmic sperm injection following microepididymal sperm aspiration resulted in a greater number of usable blastocysts per patient. Thus, the true benefit of epididymal sperm may only be demonstrated via a comparison of cumulative pregnancy rates after multiple transfers from one cohort.

Duke Scholars

Published In

Asian J Androl

DOI

EISSN

1745-7262

Publication Date

2020

Volume

22

Issue

2

Start / End Page

222 / 226

Location

China

Related Subject Headings

  • Testis
  • Spermatozoa
  • Sperm Retrieval
  • Sperm Injections, Intracytoplasmic
  • Pregnancy Rate
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Morin, S. J., Hanson, B. M., Juneau, C. R., Neal, S. A., Landis, J. N., Scott, R. T., & Hotaling, J. M. (2020). A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia. Asian J Androl, 22(2), 222–226. https://doi.org/10.4103/aja.aja_58_19
Morin, Scott J., Brent M. Hanson, Caroline R. Juneau, Shelby A. Neal, Jessica N. Landis, Richard T. Scott, and James M. Hotaling. “A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia.Asian J Androl 22, no. 2 (2020): 222–26. https://doi.org/10.4103/aja.aja_58_19.
Morin SJ, Hanson BM, Juneau CR, Neal SA, Landis JN, Scott RT, et al. A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia. Asian J Androl. 2020;22(2):222–6.
Morin, Scott J., et al. “A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia.Asian J Androl, vol. 22, no. 2, 2020, pp. 222–26. Pubmed, doi:10.4103/aja.aja_58_19.
Morin SJ, Hanson BM, Juneau CR, Neal SA, Landis JN, Scott RT, Hotaling JM. A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia. Asian J Androl. 2020;22(2):222–226.
Journal cover image

Published In

Asian J Androl

DOI

EISSN

1745-7262

Publication Date

2020

Volume

22

Issue

2

Start / End Page

222 / 226

Location

China

Related Subject Headings

  • Testis
  • Spermatozoa
  • Sperm Retrieval
  • Sperm Injections, Intracytoplasmic
  • Pregnancy Rate
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Male
  • Humans
  • Female