MP43-05 TESTICULAR SPERM ASPIRATION (TESA) VS. MICROFLUIDIC SPERM SEPARATION (MSS) IN COUPLES WITH HIGH SPERM DNA FRAGMENTATION UNDERGOING ICSI: WHICH APPROACH IS BETTER?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP43-05 TESTICULAR SPERM ASPIRATION (TESA) VS. MICROFLUIDIC SPERM SEPARATION (MSS) IN COUPLES WITH HIGH SPERM DNA FRAGMENTATION UNDERGOING ICSI: WHICH APPROACH IS BETTER? Rabea Akram, Karen Kteily, Michael Maalouf, Ahmad Alshammari, Simon Phillips, and Armand Zini Rabea AkramRabea Akram More articles by this author , Karen KteilyKaren Kteily More articles by this author , Michael MaaloufMichael Maalouf More articles by this author , Ahmad AlshammariAhmad Alshammari More articles by this author , Simon PhillipsSimon Phillips More articles by this author , and Armand ZiniArmand Zini More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular sperm aspiration (TESA) and microfluidic sperm separation (MSS) are modalities designed to select the best sperm quality for intra-cytoplasmic sperm injection (ICSI) in men with poor sperm DNA integrity. We sought to investigate and compare reproductive outcomes in couples with a high sperm DNA fragmentation index (DFI) using TESA-ICSI or MSS-ICSI. METHODS: We conducted a retrospective study of consecutive infertile couples with high DFI who underwent ICSI using TESA, or MSS. Couples were divided into 3 subgroups based on sperm DFI results (20-29%, ≥30-39% and ≥40% DFI). Sperm DFI was determined by flow cytometry based TUNEL assay (terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling). We utilized the ZyMōt® microfluidic sperm selection device. We excluded cycles with advanced maternal age (>40 years) and included cycles with transfer of day 5 blastocysts. RESULTS: After excluding cycles with advanced maternal age and those that did not proceed to day 5 blastocyst transfer, we identified 66 couples in the TESA cohort and 73 couples in the MSS cohort. Maternal age was not significantly different in the TESA vs. the MSS cycles in any of the DFI subgroups. However, paternal age was significantly higher in the TESA than in the MSS cycles within the 20-29% and 30-39% DFI subgroups (Table 1). There were no significant differences in pregnancy rates per embryo transfer in any of the DFI subgroups, However, live birth rates were higher in the MSS vs. the TESA cycles in the 20-29% DFI group. A trend toward higher live birth rates in the TESA vs. MSS cycles in the ≥40% DFI subgroup was noted (Table 1). CONCLUSIONS: TESA-ICSI and MSS-ICSI offer similar pregnancy rates per embryo transfer in couples with high DFI although MSS may be a better option than TESA in terms of live birth rates in couples with DFI in the 20-29% range. Larger studies are needed to define the optimal use of these sperm selection modalities in the treatment of couples with high DFI. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e602 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rabea Akram More articles by this author Karen Kteily More articles by this author Michael Maalouf More articles by this author Ahmad Alshammari More articles by this author Simon Phillips More articles by this author Armand Zini More articles by this author Expand All Advertisement PDF downloadLoading ...