Surgical sperm extraction versus semen centrifugation: Method of spermatozoa recovery does not correlate with euploidy rates in patients with cryptozoospermia

Abstract

Objective
 The aim of this study is to evaluate the rate of embryonic euploidy in blastocysts derived from testicular versus ejaculated sperm in cryptozoospermic patients.
 Design
 Retrospective cohort analysis.
 Material and methods
 The study included couples who suffer from Cryptozoospermia and underwent an autologous in vitro fertilization (IVF) with preimplantation genetic testing (PGT-A) cycle(s) from 2014 to 2019. Only cases where oocyte insemination was conducted with intra-cytoplasmic sperm injection (ICSI) were evaluated. Cohorts were separated based on the source of sperm (Ejaculated vs. Testicular (TESE)). Demographic and clinical embryology parameters were compared among cohorts. Student’s t-test, Wilcoxon’ rank test, chi-square test, and multivariate logistic regression fitted with a GEE model were used for data analysis.
 Results
 A total of 573 blastocysts derived from 87 IVF/PGT-A cases were included in the study. 74 cases (n= 474 embryos) utilized ejaculated sperm and 13 cases (n= 99 embryos) utilized testicular sperm. No significant differences were found in demographic and stimulation parameters among cohorts. (Table 1) No differences among the ejaculated and testicular cohorts were found in fertilization rate (63.2%; 61.1%, p=0.32); blastulation rate (64.5%; 66.6%, p=0.69); and rate of embryo euploidy (49.7%; 52.1%, p=0.76) respectively. No differences were found in rate of cycle cancellation due to unavailable embryos for TE biopsy (18.9% vs 7.6%, p=0.32).
 Conclusions
 There is no genomic advantage to surgical sperm retrieval in cryptozoospermic patients.