TY - JOUR
T1 - Fertility outcomes after extended searches for ejaculated spermatozoa in men with virtual azoospermia
AU - Miller, Netanella
AU - Biron-Shental, Tal
AU - Pasternak, Yael
AU - Belenky, Michael
AU - Shefi, Shai
AU - Itsykson, Pavel
AU - Berkovitz, Arie
N1 - Publisher Copyright:
© 2017 American Society for Reproductive Medicine
PY - 2017/6
Y1 - 2017/6
N2 - Objective To assess the fertility outcomes of extended searches for ejaculated spermatozoa in men with virtual azoospermia. Design A retrospective cohort of 242 couples whose male partner suffered from nonobstructive azoospermia and who were treated with the use of intracytoplasmic sperm injection (ICSI). Setting Not applicable. Patient(s) One hundred forty patients were referred to an extended search in the ejaculate and 102 patients were referred to microsurgical testicular sperm extraction (microTESE). Intervention(s) None. Main Outcome Measure(s) Rates of sperm retrieval, fertilization, and pregnancy, take-home baby rate, and missed abortion rate were analyzed and compared. Result(s) In the ejaculated spermatozoa group, motile spermatozoa were retrieved in 91 cases (65%) and on oocyte pick-up day in 71 cases (78%), compared with 70 cases (68%) in the microTESE group, with a similar incidence of sperm retrieval between groups. No significant difference was found between groups regarding mean number of embryo transfer and fertilization and pregnancy rates. There was no significant difference between groups regarding take-home baby rate. A significantly higher first-trimester missed abortion rate was found in the ejaculated sperm group (n = 14; 52%) compared with the microTESE group (n = 3; 8.6%). Conclusion(s) Conducting an extended spermatozoa search in the ejaculate of men with virtual azoospermia can provide pregnancy rates similar to those obtained with the use of microTESE, with a higher rate of spontaneous abortions in the ejaculate group.
AB - Objective To assess the fertility outcomes of extended searches for ejaculated spermatozoa in men with virtual azoospermia. Design A retrospective cohort of 242 couples whose male partner suffered from nonobstructive azoospermia and who were treated with the use of intracytoplasmic sperm injection (ICSI). Setting Not applicable. Patient(s) One hundred forty patients were referred to an extended search in the ejaculate and 102 patients were referred to microsurgical testicular sperm extraction (microTESE). Intervention(s) None. Main Outcome Measure(s) Rates of sperm retrieval, fertilization, and pregnancy, take-home baby rate, and missed abortion rate were analyzed and compared. Result(s) In the ejaculated spermatozoa group, motile spermatozoa were retrieved in 91 cases (65%) and on oocyte pick-up day in 71 cases (78%), compared with 70 cases (68%) in the microTESE group, with a similar incidence of sperm retrieval between groups. No significant difference was found between groups regarding mean number of embryo transfer and fertilization and pregnancy rates. There was no significant difference between groups regarding take-home baby rate. A significantly higher first-trimester missed abortion rate was found in the ejaculated sperm group (n = 14; 52%) compared with the microTESE group (n = 3; 8.6%). Conclusion(s) Conducting an extended spermatozoa search in the ejaculate of men with virtual azoospermia can provide pregnancy rates similar to those obtained with the use of microTESE, with a higher rate of spontaneous abortions in the ejaculate group.
KW - ICSI
KW - Virtual azoospermia
KW - ejaculated spermatozoa
KW - intracytoplasmic sperm injection
KW - live birth rate
KW - microTESE
KW - pregnancy rate
UR - http://www.scopus.com/inward/record.url?scp=85018778657&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2017.04.005
DO - 10.1016/j.fertnstert.2017.04.005
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C2 - 28483501
AN - SCOPUS:85018778657
SN - 0015-0282
VL - 107
SP - 1305
EP - 1311
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 6
ER -