| dc.description.abstract | Study question: To determine whether the outcome of ICSI with testicular
spermatozoa obtained microscopically assisted testicular sperm extraction
(m-TESE) is dependent on the number of MII oocytes.
Summary answer: The number of the mature oocytes is an important prognostic factor in ICSI with testicular spermatozoa obtained from azoospermic
men.
What is known already: Retrieval of healthy oocytes is a key component of
assisted reproductive treatment for infertile couples. Intracytoplasmic sperm
injection (ICSI) has been commonly used for couples with male infertility
since its first successful introduction in 1992 and reliable pregnancy rates were
achieved by using testicular spermatozoa from patient with azoospermia. Study design, size, duration: A retrospective cohort of women 40 years old
who underwent ICSI treatment with testicular spermatozoa were included from
2006 to 2013.
Participants/materials, setting, methods: Women were enrolled only for one
cycle. ICSI was performed with motile testicular spermatozoa obtained from
89 men with obstructive azoospermia and 251 men with nonobstructive azoospermia. GnRH antagonist protocol was used for ovulation induction. Simple
linear regression was carried out between the number of MII oocytes and the
live birth rate. Receiver operator characteristic (ROC) curves were formed to
detect a cut-off number of MII oocytes below which live birth rate was significantly decreased.
Main results and the role of chance: The live birth rate was significantly
higher in ICSI-mTESE cycles with ≥7 MII oocytes than that with <7 oocytes
(30.6% vs. 14.3%, respectively, r = 0.12, p = 0.02). LBRs were the lowest in
cycles with one or two MII oocytes available (9% and 9%, respectively), but
these rates were not statistically different than cycles with 3,4,5 and 6 MII
oocytes (14.8%, 16.6%, 17.8%, 23%, respectively, p>0.05). Embryo transfer
was not achieved in 37 cycles with <7 oocytes (37/167, 22.1%) and 18 cycles
with ≥7 oocytes (18/173, 10.4%) because of the absence embryos available
following ICSI (p < 0.01).
Limitations, reasons for caution: The limitations of the present study were the
retrospective design and relatively small number of ICSI cycles with testicular
spermatozoa.
Wider implications of the findings: Our current findings imply that obtaining
low numbers of oocytes is associated with impaired pregnancy rate in ICSI with
m-tese cycles.
Trial registration number: Instutional Ethics committe number: 2016-012. | en_US |
