Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy


Autoři: Pin-Yao Lin aff001;  Chun-Chia Huang aff001;  Hsiu-Hui Chen aff001;  Bo-Xuan Huang aff003;  Maw-Sheng Lee aff001
Působiště autorů: Division of Infertility, Lee Women's Hospital, Taichung, Taiwan aff001;  Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan aff002;  Department of Urology, Puli Christian Hospital, Nantou, Taiwan aff003;  Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224919

Souhrn

Purpose

Unexpected sperm retrieval failure on the day of oocyte retrieval is not common but frequently happened in patients with severe oligospermia or non-obstructive azoospermia(NOA). Oocyte cryopreservation is a common strategy after failed collection of sperm when concurrent ovarian stimulation is underwent. However, the use of oocyte vitrification in such male-infertility cases remains unclear.

Objective

To investigate the outcomes of emergent oocyte cryopreservation after failed sperm retrieval from severe oligospermic or non-obstructive azoospermic (NOA) patients on oocyte retrieval day.

Methods

Design: Retrospective cohort study

Setting: Academic fertility center at Lee Women's Hospital, Taiwan, between March 2015 and August 2017.

Patients: For 203 couples with NOA(n = 200) or severe oligospermia(n = 3), testicular spermatozoa (n = 67 cycles) or frozen donor sperm (n = 209 cycles) were injected into fresh or frozen-thawed oocytes via 276 intracytoplasmic sperm injection (ICSI) cycles.

Main Outcome Measures: Clinical pregnancy and live-birth rates (LBRs).

Results

In the 67 cycles involving the use of fresh testicular spermatozoa, no significant differences were observed between fresh and warmed oocytes with respect to the fertilization rates (69.2% vs. 74.1%; p = 0.27), number of Day-3 embryos (8.6±4.4 vs. 6.4±3.4; p = 0.08), number of good-quality Day-3 embryos (4.5±3.9vs. 4.7±3.0; p = 0.45), implantation rates (29.1% vs. 17.8%; p = 0.21), clinical pregnancy rates (36.4% vs. 26.8.0%; p = 0.81), live birth rates (36.4% vs. 14.3%; p = 0.46), or perinatal outcomes. In the 209 cycles involving the use of frozen donor sperm, no significant differences were seen between the two groups, except that the mean birth weights were significantly lower with fresh oocyte pregnancies than with warmed oocytes (2952±196 gm vs 2643±700 gm; p = 0.006).

Conclusions

Emergent oocyte cryopreservation is a feasible strategy to manage unexpected sperm retrieval failure from severe oligospermic or NOA patients on the oocyte retrieval day. There is no detrimental effect on the live birth rate when testicular spermatozoa or frozen donor sperm are injected into the thawed oocytes compared with fresh oocytes.

Klíčová slova:

Birth rates – Cryopreservation – Embryos – Fertilization – Oocytes – Pregnancy – Sperm – Surgical and invasive medical procedures


Zdroje

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