PD01-01 SURGICALLY ACQUIRED SPERM USE FOR ASSISTED REPRODUCTIVE TECHNOLOGY: TRENDS AND PERINATAL OUTCOMES, UNITED STATES, 2004-2015

Abstract

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2018PD01-01 SURGICALLY ACQUIRED SPERM USE FOR ASSISTED REPRODUCTIVE TECHNOLOGY: TRENDS AND PERINATAL OUTCOMES, UNITED STATES, 2004-2015 Jennifer Kawwass, Jeani Chang, Sheree Boulet, Ajay Nangia, Akanksha Mehta, and Dmitry Kissin Jennifer KawwassJennifer Kawwass More articles by this author , Jeani ChangJeani Chang More articles by this author , Sheree BouletSheree Boulet More articles by this author , Ajay NangiaAjay Nangia More articles by this author , Akanksha MehtaAkanksha Mehta More articles by this author , and Dmitry KissinDmitry Kissin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.214AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The impact of mode of semen acquisition on reproductive outcomes among couples undergoing treatment with assisted reproductive technology (ART) has not been well characterized. We investigated national trends, and compared pregnancy and perinatal outcomes between surgically acquired and ejaculated sperm use among fresh, non-donor in vitro fertilization cycles in which the male partner has infertility. METHODS This retrospective cohort study used data from U.S. fertility clinics reporting to the National ART Surveillance System (NASS) between 2004 and 2015 (n=369,426 fresh non-donor cycles with male factor infertility). We assessed trends in use of surgically acquired (testicular and epididymal) and ejaculated sperm using the Cochran-Armitage test. To the subset of these ART cycles that used intracytoplasmic sperm injection (ICSI) (n=347,078 cycles), we applied multivariable log binomial regression to compare pregnancy and perinatal outcomes for cycles that used surgically acquired versus ejaculated sperm. Outcomes examined included biochemical pregnancy, intrauterine pregnancy, and live birth (>20 weeks) per embryo transfer cycle; miscarriage (<20 weeks) and singleton live birth per pregnancy; and normal birthweight (>2500g) and full term delivery (>37 weeks) per singleton pregnancy. We performed subgroup analyses for cycles with a sole diagnosis of male factor infertility (no female factors) and for the subset of such cycles in which the female partner was under 35 years old. RESULTS Percentage of cycles in which the male partner had male factor infertility that used surgically acquired sperm increased over the study period (9.8% in 2004 to 11.6% in 2015, p<0.05). The proportion of cycles using testicular sperm also increased significantly over the study period (4.9% in 2004 to 6.5% in 2015, p<0.05); no change was detected for epididymal sperm use. Among fresh, non-donor ICSI cycles for patients with male factor infertility, outcomes were similar between cycles involving epididymal sperm and cycles involving testicular sperm versus those using ejaculated sperm. Results were similar for both subgroup analyses. CONCLUSIONS Surgically acquired sperm use increased over the study period. Mode of semen acquisition does not appear to significantly impact pregnancy and perinatal outcomes among couples undergoing IVF ICSI for treatment of male factor infertility. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e60 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jennifer Kawwass More articles by this author Jeani Chang More articles by this author Sheree Boulet More articles by this author Ajay Nangia More articles by this author Akanksha Mehta More articles by this author Dmitry Kissin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...