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Fertil Steril. 2009 Oct;92(4):1333-6. doi: 10.1016/j.fertnstert.2008.07.1776. Epub 2008 Sep 30.

Fresh testicular sperm retrieved from men with spinal cord injury retains equal fecundity to that from men with obstructive azoospermia via intracytoplasmic sperm injection.

Author information

1
Kyono Art Clinic and Reproduction Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan. skanto@ivf-kyono.or.jp

Abstract

OBJECTIVE:

To examine the outcomes of intracytoplasmic sperm injection (ICSI) with testicular sperm retrieved from men with spinal cord injury.

DESIGN:

Retrospective study.

SETTING:

Private hospital-based infertility research laboratory.

PATIENT(S):

Twenty-two couples of whom one partner was a man with spinal cord injury (SCI).

INTERVENTION(S):

Reviewing the outcomes of testicular sperm extraction (TESE)-ICSI.

MAIN OUTCOME MEASURE(S):

Testicular sperm retrieval rate, fertilization rate, pregnancy rate, comparison with patients with obstructive azoospermia.

RESULT(S):

Testicular sperm were retrieved from 19 of 22 (86%) patients with SCI. Intracytoplasmic sperm injection resulted in a fertilization rate of 236 of 364 (65%). Of 19 couples, 14 couples achieved 18 pregnancies, and 22 infants (14 singleton and 4 twin) were born. (Pregnancy per couple was 74% and that per ICSI was 54%). There was no significant difference in pregnancy rate at the first ICSI between SCI couples and obstructive azoospermia couples (68% SCI, 68% obstructive azoospermia). However, pregnancy rate per fresh testicular sperm-ICSI was significantly higher than that per frozen-thawed sperm-ICSI in SCI couples (64% SCI fresh, 25% SCI frozen-thawed) although no significant difference was seen in obstructive azoospermia couples (76% obstructive azoospermia fresh, 63% obstructive azoospermia frozen-thawed). There was no significant difference in pregnancy rate between fresh ET cycle and frozen-thawed ET cycle in SCI couples.

CONCLUSION(S):

Testicular sperm in men with SCI may possess disadvantages in freezing and thawing compared with that in men with obstructive azoospermia. Fresh testicular sperm-ICSI may offer optimum outcome for SCI couples desirous of pregnancy.

[Indexed for MEDLINE]

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