Testicular versus ejaculated spermatozoa in ICSI cycles of normozoospermic men with high sperm DNA fragmentation and previous ART failures.

Autor: Pabuccu EG; Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey., Caglar GS; Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey., Tangal S; Ufuk University School of Medicine, Department of Urology, Ankara, Turkey., Haliloglu AH; Ufuk University School of Medicine, Department of Urology, Ankara, Turkey., Pabuccu R; Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.; Centrum Clinic Women's Health and ART Center, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Andrologia [Andrologia] 2017 Mar; Vol. 49 (2). Date of Electronic Publication: 2016 Apr 25.
DOI: 10.1111/and.12609
Abstrakt: As a part of male assessment, conventional sperm parameters including morphologic features have been dedicated as major factors influencing fertilisation and pregnancy rates in assisted reproductive technology (ART). Genomic integrity of spermatozoa has also been found to influence fertility prognosis, and hence, sperm DNA fragmentation index (DFI) has been adopted by many centres to document this entity. Despite several suggested approaches, there is lack of universal consensus on optimising fertility outcomes in males with high sperm DFI. In this context, the results from cycles using testicular spermatozoa (TESA) obtained by aspiration were compared with those of ejaculated spermatozoa (EJ) in normozoospermic subjects with high sperm DFI and previous ART failures. Clinical (41.9% versus 20%) and ongoing pregnancy rates (38.7% versus 15%) were significantly better and miscarriages were lower in TESA group when compared to EJ group. Sperm DFI should be a part of male partner's evaluation following unsuccessful ART attempts. When high DFI is detected (>30%), ICSI using testicular spermatozoa obtained by TESA seems an effective option particularly for those with repeated ART failures in terms of clinical, ongoing pregnancies and miscarriages even though conventional sperm parameters are within normal range.
(© 2016 Blackwell Verlag GmbH.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje