The influence of testicular sperm on IVF-ET outcomes in patients with severe asthenozoospermia
Objective To investigate the effect percutaneous testicular sperm aspiration(TE-SA)on the outcomes of in vitro fertilization embryo transfer(IVF-ET)in cases of patients with severe asthenozoospermia undergoing intracytoplasmic sperm injection(ICSI)when no motile sperm or coiled-tail sperm are identified in the ejaculated semen.Methods A retrospective cohort study was used to analyze the clinical data of 136 couples with severe asthenozoospermia and 74 couples with completely immobile sperm who underwent ICSI in the Assisted Reproductive Center of Northwest Women's and Children's Hospital from January 1,2016,to April 1,2021.Male patients were divided into three groups according to the source of the male spermatozoa on the day of oocyte retrieval by the female part-ner:ejaculatory progressive motile sperm group(Ep group,sperm motility＜1％,grade A or B sperm with normal morphology can be found,68 cases),ejaculated non progressive motile sperm group(En group,sperm motility=0％,grade C or spermcoiled-tail sperm with normal morphology can be found,68 cases)and testicular sperm puncture group(TESA group,underwent TESA,with no active or coiled-tail sperm found in the ejaculated semen,74 cases).The general data and ICSI outcomes of the three groups were compared.Results The available embryo rate,high-quality embryo rate,normal fertiliza-tion rate,clinical pregnancy rate,and live birth rate in the Ep group were higher than those in the En group.However,the abortion rate was lower in the Ep group compared to the En group,although the difference was not statistically significant(all P＞0.05).The high-quality embryo rate,clinical preg-nancy rate,and abortion rate in the TESA group were lower than those in the Ep and En groups,while the live birth rate and normal fertilization rate were higher than those in the Ep and En groups.Never-theless,the differences were not statistically significant(all P＞0.05).Conclusions Patients diag-nosed with severe asthenozoospermia,characterized by the absence of motile or coiled-tail sperm in e-jaculated semen,who undergo TESA-ICSI do not experience any negative impact on oocyte fertilization or embryo quality.In addition,there is no significant difference in clinical outcomes after fresh trans-plantation compared to the use of motile or coiled sperm.
AsthenozoospermiaIntracytoplasmic Sperm InjectionFertilization in VitroEm-bryo Transfer
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