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4 results

  • Chapter 15 - Processing Surgically Retrieved Sperm in the IVF Laboratory

  • from Section 3 - Gametes
  • Edited by Markus H. M. Montag, ilabcomm GmbH, St Augustin, Germany, Dean E. Morbeck, Kindbody Inc, New York City
  • Book:
    Principles of IVF Laboratory Practice
    Published online:
    07 August 2023
    Print publication:
    24 August 2023, pp 114-120

  • Summary

    Infertility due to azoospermia may be overcome by surgically retrieving sperm from the epididymis or testicle followed by in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) and embryo transfer. The nature of the azoospermia (obstructive (OA) versus non-obstructive azoospermia (NOA)), the surgical approach (percutaneous versus open) and the timing of the sperm retrieval relative to oocyte retrieval for IVF/ICSI (fresh versus frozen sperm) contribute to the success of sperm retrieval and the number of viable sperm that will be available for the IVF/ICSI procedure. The goal of the surgical team should be to maximize the recovery of mature, viable sperm for ICSI while minimizing patient risk and cost. The laboratory processing the samples must minimize post-recovery cell damage, preserve sample sterility and strive to optimize the efficiency of the surgery when possible by cryopreserving excess sperm for future IVF/ICSI procedures. Lastly, these teams must work together to optimize the ease of surgery coordination with the IVF procedure. The relevant procedures for sperm preparation from epidymal aspirates or testicular biopsies will be described in this chapter.

  • A cryoprotectant supplemented with pentoxifylline can improve the effect of freezing on the motility of human testicular sperm

  • Yang Xian, Min Jiang, Bo Liu, Wenrui Zhao, Bin Zhou, Xiao Liu, Shasha Liu, Fuping Li
  • Journal:
    Zygote / Volume 30 / Issue 1 / February 2022
    Published online by Cambridge University Press:
    22 June 2021, pp. 92-97

  • This study examined the effect of a cryoprotectant with and without pentoxifylline supplementation on the motility and viability of human testicular sperm, both before and after freezing. Testicular samples were obtained from 68 patients with azoospermia who came to the Andrology Service of West China Second University Hospital, Sichuan University, for testicular biopsies from December 2019 to April 2020. All patients were assigned randomly to two groups: experimental, whose testicular sperm were added to the cryoprotectant with pentoxifylline, and the control, whose testicular sperm were added to the cryoprotectant without pentoxifylline. Both groups used the same freezing and thawing methods. Testicular sperm motility in the experimental group was significantly higher than that of the control group, both before and after cryopreservation. The recovery rate of sperm motility in the experimental group was significantly higher than that of the control group. The percentage of samples with motile testicular sperm in the experimental group was significantly higher than that of the control group after thawing. Sperm viability was unchanged between the experimental and control groups, both before and after freezing. Overall, a pentoxifylline-supplemented cryoprotectant can significantly improve the motility of testicular sperm before and after cryopreservation.

  • Chapter 8 - Sperm Retrieval in Non-azoospermic Men

  • from Part II - Sperm Retrieval
  • Edited by Ashok Agarwal, Ahmad Majzoub, Sandro C. Esteves
  • Book:
    Manual of Sperm Retrieval and Preparation in Human Assisted Reproduction
    Published online:
    09 April 2021
    Print publication:
    10 June 2021, pp 56-74

  • Summary

    Sperm retrieval and intracytoplasmic sperm injection (ICSI) has become the natural treatment for couples with azoospermia-related infertility, and nowadays is also used for nonazoospermic indications. An increasing body of evidence overwhelmingly based on cohort studies has indicated that ICSI with ejaculated sperm of poor quality negatively affects the chances of assisted conception. Collectively, these data suggest that ICSI with testicular sperm is superior to ICSI with ejaculated sperm as a method of fertilization to overcome sperm DNA fragmentation-related infertility. The candidates are men with high sperm DNA damage in semen and those with severe oligozoospermia or cryptozoospermia. In these patients, percutaneous and open sperm retrieval are highly successful to harvest sperm, with few complications. Current evidence suggests the safe utilization of testicular sperm for ICSI in nonazoospermic men. Further research is warranted to confirm the clinical utility of this approach as a routine ART treatment.

  • Chapter 29 - In-vitro fertilization and micromanipulation for male infertility

  • Edited by Larry I. Lipshultz, Stuart S. Howards, University of Virginia, Craig S. Niederberger, University of Illinois, Chicago
  • Book:
    Infertility in the Male
    Published online:
    19 May 2010
    Print publication:
    24 September 2009, pp 500-515

  • Summary

    This chapter provides a comprehensive review of the available techniques for sperm retrieval, along with a brief description of the subtleties of each surgery. It describes the assessment of the outcomes associated with the various sperm retrieval techniques, based on the available literature. As in the obliterative microsurgical epididymal sperm aspiration (MESA) technique, inspection of epididymal tubules begins at the cauda and progresses proximally toward the head of the epididymis. Percutaneous epididymal sperm aspiration (PESA) may be performed to obtain sperm for in-vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI). It can be done with a local anesthetic in an office setting. For cases of severe male-factor infertility such as nonobstructive azoospermia, or for obstructive azoospermia, testicular sperm may be used for IVF/ICSI. In the setting of normal spermatogenesis and vasal obstruction, either iatrogenic or congenital, sperm may be aspirated from the lumen of the testicular end of the vas deferens.