Intracytoplasmic Sperm Injection In Men Research Articles

Factors affecting successful outcome from ICSI in men following previous vasectomy

There are conflicting reports as to whether the interval between vasectomy and surgical sperm retrieval (SSR) for intra-cytoplasmic sperm injection (ICSI) is related to clinical pregnancy (CPR), and live birth (LBR), rates. This study aimed to evaluate factors that may influence the outcome of ICSI in males with secondary azoospermia due to previous vasectomy. We analysed the medical records of 198 azoospermic males following vasectomy who underwent percutaneous epididymal sperm aspiration (PESA) and/or testicular sperm extraction (TeSE), between 1997 and 2005 by a single urologist, and whose sperm was subsequently frozen for use in an IVF treatment programme on their partner's behalf. Hundred and forty-four (73%) males had a positive PESA, and the remaining 54 (27%) had a positive TeSE. Forty-four percent of males with no clinical evidence of epididymal distension still had epididymal sperm retrieved successfully. Hundred and twenty-eight patients proceeded with ICSI, and a total of 237 cycles were performed. The CPR and LBR overall were 29 and 27%, respectively. Using logistic regression there was no association between time since vasectomy and CPR (P = 0.17) or LBR (P = 0.31). A history of an attempted reversal of vasectomy did not negatively affect retrieval rates or CPR and LBR. The success of SSR and the outcome of ICSI, using frozen sperm, are independent of male age and time since vasectomy. Epididymal sperm may be retrieved in over 40% of men in whom there is no clinical evidence of epididymal distension.

Gonadotrophin therapy in combination with ICSI in men with hypogonadotrophic hypogonadism

The aim of this study was to evaluate the impact of gonadotrophin therapy in combination with intracytoplasmic sperm injection (ICSI) in men with hypogonadotrophic hypogonadism (HH). Twenty-five azoospermic men were diagnosed with HH due to low FSH, LH and total testosterone concentrations. These patients were treated with human chorionic gonadotrophin for 1 month plus recombinant FSH the following month. Total testosterone concentrations were measured in the first and third months. Semen analyses were performed monthly after the third month of treatment. ICSI was performed when sperm production commenced. Total testosterone concentration and testicular volume were significantly increased after gonadotrophin therapy (P < 0.001). On average, spermatozoa were detected in the ejaculate after 10 months. Spontaneous pregnancies were achieved in four couples. Twenty-two ICSI cycles were performed in 18 couples using ejaculated or testicular spermatozoa, and 12 pregnancies (54.5% per cycle) were achieved. These results showed that HH could be treated successfully with hormonal therapy combined with ICSI using ejaculated spermatozoa. The use of ICSI made it possible to achieve pregnancy when spermatozoa appeared in the ejaculate, and shortened the duration of gonadotrophin therapy.

1406: Testicular Sperm Extraction Combined with Intracytoplasmic Sperm Injection in Men with Postchemotherapy Azoospermia

You have accessJournal of UrologyModerated Poster, Tuesday, May 23, 2006, 3:30 - 5:30 pm1 Apr 20061406: Testicular Sperm Extraction Combined with Intracytoplasmic Sperm Injection in Men with Postchemotherapy Azoospermia Hiroshi Okada, Osamu Maruyama, Kojiro Nishio, Keisuke Saito, Takashi Yoshii, Yoshio Ashizawa, Koji Kurihara, Shuji Isotani, Yutaka Kamiyama, Hisamitsu Ide, Satoru Muto, and Shigeo Horie Hiroshi OkadaHiroshi Okada More articles by this author , Osamu MaruyamaOsamu Maruyama More articles by this author , Kojiro NishioKojiro Nishio More articles by this author , Keisuke SaitoKeisuke Saito More articles by this author , Takashi YoshiiTakashi Yoshii More articles by this author , Yoshio AshizawaYoshio Ashizawa More articles by this author , Koji KuriharaKoji Kurihara More articles by this author , Shuji IsotaniShuji Isotani More articles by this author , Yutaka KamiyamaYutaka Kamiyama More articles by this author , Hisamitsu IdeHisamitsu Ide More articles by this author , Satoru MutoSatoru Muto More articles by this author , and Shigeo HorieShigeo Horie More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)33610-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1406: Testicular Sperm Extraction Combined with Intracytoplasmic Sperm Injection in Men with Postchemotherapy Azoospermia." The Journal of Urology, 175(4S), pp. 453–454 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 453-454 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Hiroshi Okada More articles by this author Osamu Maruyama More articles by this author Kojiro Nishio More articles by this author Keisuke Saito More articles by this author Takashi Yoshii More articles by this author Yoshio Ashizawa More articles by this author Koji Kurihara More articles by this author Shuji Isotani More articles by this author Yutaka Kamiyama More articles by this author Hisamitsu Ide More articles by this author Satoru Muto More articles by this author Shigeo Horie More articles by this author Expand All Advertisement PDF downloadLoading ...

Success of Testicular Sperm Injection and Intracytoplasmic Sperm Injection in Men With Klinefelter Syndrome

Success of Testicular Sperm Injection and Intracytoplasmic Sperm Injection in Men With Klinefelter Syndrome

Success of Testicular Sperm Injection and Intracytoplasmic Sperm Injection in Men with Klinefelter Syndrome

The aim of this study was to report the successful fertility treatment of men with Klinefelter syndrome using testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI). A total of 42 men with Klinefelter syndrome who underwent 54 TESE procedures were identified. Before TESE, patients with serum testosterone levels less than 15.6 nmol/liter were treated with an aromatase inhibitor. Sperm retrieval rates and results of ICSI, including fertilization and clinical pregnancy, were collected. Mean pretreatment FSH and testosterone levels were 33.2 IU/liter and 9.8 nmol/liter. During medical therapy, the mean testosterone level rose to 17.0 nmol/liter (P < 0.01). Spermatozoa were found during 39 microdissection TESE procedures, on the day before, or day of oocyte retrieval during a programmed in vitro fertilization cycle. The sperm retrieval rate was 72% (39 of 54) per TESE attempt, and 29 of the 42 different men (69%) had adequate sperm found for ICSI. Thirty-three in vitro fertilization cycles yielded embryos for transfer in the 39 (85%) cycles with sperm retrieved. Eighteen clinical pregnancies have resulted in 21 live births [18 of 39 (46%)]. All children had a normal karyotype. TESE/ICSI is a successful intervention for the majority of patients with azoospermia and Klinefelter syndrome. Sperm retrieval and ICSI success in men with Klinefelter syndrome are comparable with other men with nonobstructive azoospermia treated at our center.

Limitations of cryopreserved sperm for ICSI in men with nonobstructive azoospermia

Objective: Men with nonobstructive azoospermia (NOA) may have sperm retrieved from testicular tissue for use in intracytoplasmic sperm injection (ICSI). While cryopreserved sperm from men with obstructive azoospermia have been used for ICSI as effectively as fresh sperm in this population, it is unclear if the low numbers of sperm retrieved from men with NOA survive the freeze/thaw process sufficiently for use in ICSI. We have assessed the effect of freeze/thaw on sperm from men with NOA and present the results of ICSI using frozen-thawed testicular sperm in NOA.

Y chromosome analysis of infertile men and their sons conceived through intracytoplasmic sperm injection: vertical transmission of deletions and rarity of de novo deletions

Objective: To determine the prevalence and type of Yq microdeletions in 86 consecutive men that fathered 99 sons by intracytoplasmic sperm injection (ICSI) and to determine the incidence of vertical transmission and de novo deletions in these boys. Design: Prospective clinical observational study. Setting: Genetics laboratory associated with a university IVF unit. Patient(s): Eighty-six consecutive infertile men presenting to an IVF clinic and their 99 ICSI-conceived sons. Fifty of the 86 men (58%) had idiopathic seminiferous tubule failure (STF); the remainder had a variety of other clinical indications for ICSI. Intervention(s): Collection of peripheral and cord blood samples. Main Outcome Measure(s): The Yq genetic status of fathers who underwent ICSI and of their sons by the presence or absence of 22 Y-specific markers covering the four azoospermia factor (AZF) subregions. Result(s): Yq deletions of the AZFd/c region were detected in two (6.9%) of 29 azoo- or severely oligospermic men with STF. Identical deletions were found in their respective sons. No de novo deletions were detected in the remaining 97 sons conceived by men without deletions. Conclusion(s): The detection of Yq deletions only in men with severe STF is consistent with previous studies, with the AZFd/c region being most commonly affected. This study demonstrates the vertical transmission of these Yq deletions through the use of ICSI and supports the notion that, in most cases, Yq deletions will be inherited by male offspring. The absence of de novo Yq deletions in the male offspring indicates that these events are rare following ICSI in men with both STF and other common male factor indications.

Intracytoplasmic Sperm Injection in Men with Totally Immotile Ejaculated Sperm

Objectives: Abnormalities of sperm motility are a poorly understood cause of male infertility, with a variety of etiologies. One of these is immotile cilia syndrome. A proportion of these cases will have classic Kartagener’s syndrome, with situs inversus. Chemes et al described another variant, with a study of patients with dysplasia of the fibrous sheath and missing or grossly distorted axonemas. We present a case series of 17 men with totally immotile ejaculated spermatozoa undergoing intracytoplasmic sperm injection (ICSI) in which four cases had short tail syndrome. Design: A prospective study of seventeen couples with totally immotile spermatozoa in the ejaculates was performed. Materials and Methods: Semen from patients with totally immotile spermatozoa were subjected to a vitality test (eosin Y 1% exclusion). When the vitality score was 0% testicular, sperm extraction (TESE) was performed (n=12). Ejaculated sperm was used in the remaining cases (n=5). A further vitality test was performed on the testicular sperm. No definite criteria were used to choose which immotile sperm were more suitable for injection. Sperm with greater tail flexibility and a more glistening head were chosen. Fertilization rates (FR) and pregnancy rates (PR) after ICSI were compared between the ejaculated and the testicular immotile spermatozoa. Electron microscopy examination (EM) of the sperm was done in 6 cases. Results: In the twelve cases of ICSI with testicular sperm extraction (TESE) the FR was 41.8% with a PR of 33.3%. In five couples, ICSI was performed using ejaculated spermatozoa, with an FR of 51.7% and a PR of 40%. The overall FR was 45.6%, with a PR of 35.3%. The ultrastructural examination showed that in two cases sperm had no dynein arms. Short tail syndrome was diagnosed in four men; three of these cases had EM showing degenerate sperm tails with short tails. In one case, there was a 5+2 axonemal pattern with degeneration, short tails, and absent dynein arms. Conclusion: ICSI using immotile testicular or ejaculated sperm is a reasonable treatment option in cases of totally immotile ejaculated spermatozoa. Pregnancy can be achieved using randomly selected ejaculate sperm or testicular sperm. Further studies are needed to assess the use of testicular versus ejaculated sperm, and the place of sperm selection methods such as the hypo-osmotic swelling test. Ultra-structural studies and advances in the genetics of sperm motility should clarify the etiology of this rare abnormality.

Intracytoplasmic sperm injection in infertile patients with structural chromosome abnormalities.

In the present study we investigated the results of cytogenetic analysis in male and female patients included in an intracytoplasmic sperm injection (ICSI) programme for severe male infertility as well as in conceptuses resulting from these ICSI treatments. In the 261 couples treated, 11 male (4.2%) and three female (1.2%) abnormal karyotypes were found, all consisting of structural chromosome anomalies. Chromosomal translocation exhibited the highest frequency (eight males and two females), and there were also three cases of chromosomal inversion (two males and one female) and one male with one additional marker chromosome. There was no difference in fertilization rates among couples with abnormal (n = 14) and normal (n = 147) cytogenetic results, and the rates of clinical pregnancy per ICSI attempt were 25.0% (5/20) and 20.6% (78/ 378) respectively. In pregnancies obtained in couples with normal karyotypes, all of the 108 fetuses were free of chromosomal abnormalities. Among the eight fetuses from couples with chromosome structural anomalies, three out of five and two out of three inherited from the cytogenetic defects found in their father or mother respectively. In this series of 83ICSI pregnancies there were no chromosomal abnormalities other than those inherited from the parents. These findings suggest that normal pregnancy rates can be obtained by ICSI in cases of chromosomal translocation in couples with severe male infertility. However, until further evaluations of available data can be performed, cytogenetic analysis must be conducted prior to ICSI in men with low sperm counts, and genetic counselling must include prenatal diagnosis for all growing conceptuses.

The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermia: Casper R.F.; Meriano J.S.; Jarvi K.A.; Cowan L.; Lucato M.L. CAN Fertil Steril 1996 65/5 (972–976)

The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermia: Casper R.F.; Meriano J.S.; Jarvi K.A.; Cowan L.; Lucato M.L. CAN Fertil Steril 1996 65/5 (972–976)

The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermia

To determine the ability of the hypo-osmotic swelling test to select viable sperm from nonmotile sperm samples for intracytoplasmic sperm injection (ICSI). Nonrandomized, sequential comparative study. Thirteen couples enrolled in our ICSI program had 16 cycles in which sperm preparations with 0% motility were obtained. Five cycles used cryopreserved epididymal sperm with complete asthenozoospermia. In eight cycles, the semen samples were washed through a Percoll gradient and sperm were selected randomly for ICSI. In another eight cycles, the washed sperm were placed in a hypo-osmotic solution (75 mM fructose; 25 mM sodium citrate dihydrate) and the sperm with curled tails taken up with the microinjection needle, rinsed, and used ICSI. Fertilization rate per oocyte injected as determined by the presence of two pronuclei at 18 hours after retrieval and embryo cleavage rate per oocyte injected at 48 hours after retrieval. With random sperm injection, the fertilization and cleavage rates were 26% and 23%, respectively. In contrast, after injection of sperm selected using the hypo-osmotic swelling test, fertilization and cleavage rates were significantly greater (43% and 39%, respectively). There were three pregnancies in the eight cycles with the hypo-osmotic swelling test-selected sperm, including two from frozen epididymal sperm. Based on these preliminary observations, we believe that the hypo-osmotic swelling test will prove to be valuable for increasing fertilization and cleavage rates and pregnancy rates in ICSI cycles where no motile sperm are recovered.