PD25-01 DOES THE USE OF TESTICULAR SPERM IMPROVE OUTCOMES IN NON-AZOOSPERMIC COUPLES WITH PREVIOUS IN-VITRO FERTILIZATION (IVF) FAILURE USING EJACULATED SPERM?

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD25)1 Apr 2020PD25-01 DOES THE USE OF TESTICULAR SPERM IMPROVE OUTCOMES IN NON-AZOOSPERMIC COUPLES WITH PREVIOUS IN-VITRO FERTILIZATION (IVF) FAILURE USING EJACULATED SPERM? M. Blake Evans, Jessica Marinaro*, Allison Eubanks, Kate Devine, Micah Hill, Alan DeCherney, Russell Hayden, Paul Shin, and Cigdem Tanrikut M. Blake EvansM. Blake Evans More articles by this author , Jessica Marinaro*Jessica Marinaro* More articles by this author , Allison EubanksAllison Eubanks More articles by this author , Kate DevineKate Devine More articles by this author , Micah HillMicah Hill More articles by this author , Alan DeCherneyAlan DeCherney More articles by this author , Russell HaydenRussell Hayden More articles by this author , Paul ShinPaul Shin More articles by this author , and Cigdem TanrikutCigdem Tanrikut More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000882.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of testicular sperm for prior in-vitro fertilization (IVF) failure has been shown to have higher clinical pregnancy rates (CPR), live birth rates (LBR), and reduced spontaneous abortion (SAB) rates compared to ejaculated sperm (ES). However, some argue that this treatment is an invasive surgical procedure without clear benefit. This study evaluates the outcomes of IVF-intracytoplasmic sperm injection (ICSI) cycles using testicular sperm in non-azoospermic couples with prior IVF failure(s) using ES. METHODS: From 1/2015 to 10/2019, 116 non-azoospermic couples with ≥1 prior IVF cycle using ES underwent testicular sperm extraction (TESE) for IVF/ICSI. Failed cycles with ES were defined as those not progressing to clinical pregnancy. Outcomes using TESE sperm were compared to the mean values of couples’ prior cycles using ES. Primary outcomes included clinical pregnancy rates (CPR) and live birth rates (LBR). Secondary outcomes included fertilization and blastocyst conversion. RESULTS: Among 116 couples, the average number of prior failed IVF cycles using ES was 2.3 (range: 1-8). A total of 140 IVF/ICSI cycles were performed using TESE sperm (116 fresh TESE sperm, 24 frozen/thawed TESE sperm). Of these, there were 71 fresh blastocyst transfers, 31 frozen blastocyst transfers (FET), and 38 cycles without transfer. There were also 9 FETs using supernumerary embryos, for a total of 111 embryo transfers. Compared to ES, IVF/ICSI using TESE sperm significantly improved blastocyst development (p=0.003), blastocyst conversion (p=0.003) and number of embryos available for vitrification (p=0.003). A subset of men (n= 66) had a sperm DNA fragmentation (SDF) assessment of ES. Mean SDF was 45% (7- 90%). Of these 66 men, 55 (83%) had an SDF >25%. The outcomes for patients with elevated SDF did not differ significantly from the overall cohort. CONCLUSIONS: In non-azoospermic couples with prior failed IVF cycles using ES, IVF/ICSI using TESE sperm may improve embryo development, CPR and LBR. Testicular sperm may avoid the adverse effects of elevated SDF from ES and improve pregnancy outcomes in some patients. Further randomized studies are needed to determine if such a benefit exists. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e538-e538 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information M. Blake Evans More articles by this author Jessica Marinaro* More articles by this author Allison Eubanks More articles by this author Kate Devine More articles by this author Micah Hill More articles by this author Alan DeCherney More articles by this author Russell Hayden More articles by this author Paul Shin More articles by this author Cigdem Tanrikut More articles by this author Expand All Advertisement PDF downloadLoading ...