The role of testicular sperm extraction in repeated intracytoplasmic sperm injection failures using ejaculate sperm

Document Type : Original Article

Authors

1 Urology, Faculty of Medicine, Beni-Suef University, Egypt

2 Urology, Resident at ministry of health.

Abstract

Objective: To assess the role of testicular sperm in improving the success rates among patients who have repeated failed intracytoplasmic sperm injection cycles using ejaculated sperm. Design: A retrospective review of records. Materials and   Methods: The study included 110 partners with repeated failed ICSI using ejaculate sperm were allocated into two groups retrospectively, one of them underwent testicular ICSI and the other underwent ejaculate ICSI. The two groups were well matched regarding their age of wife, age of husband, duration of marriage, history of previous marriage and previous children. Results: Showed that there was no statistically significant difference between patients with second ejaculate ICSI and patients with second testicular ICSI regarding the number of embryos and pregnancy rate (P- value>0.05). Patients underwent second testicular ICSI had a fertilization  rate insignificantly higher than patients underwent second ejaculate ICSI. Conclusions: ICSI using testicular extracted sperm may be considered an alternative to using second ejaculated sperm in the treatment plan of infertile couples especially if increased SDF. We infer that increased SDF may be the main cause of repeated failures of ICSI using ejaculated sperm which remains to be proved by various studies. Higher pregnancy and live birth rates are associated more with higher testicular biopsy motility per drop, testicular biopsy concentration, Number of embryos and the fertilization rate. This study recommends that men with repeated failed ejaculate ICSI with high DNA fragmentation can gain benefit from testicular ICSI in the form of increased fertilization rate, number of embryos and live birth rate.

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