Timing of Testicular Biopsy in Relation to Oocyte Retrieval and the Outcomes of Intracytoplasmic Sperm Injection.
Academic Article
Overview
abstract
PURPOSE: To evaluate microscopic testicular sperm extraction (micro-TESE) timing relative to oocyte retrieval on intracytoplasmic sperm injection (ICSI) outcome. MATERIALS AND METHODS: Couples with nonobstructive azoospermia (NOA) who underwent ICSI with freshly retrieved spermatozoa were analyzed based on whether micro-TESE was performed at least one day prior to oocyte retrieval (TESE-day-before group) or on the day of oocyte retrieval (TESE-day-of group). Embryology and clinical outcomes were compared. RESULTS: The percentage of patients who underwent a successful testicular sperm retrieval was significantly lower in the TESE-day-before cohort (62%) than in the TESE-day-of cohort (69%). (OR 1.4. 95% CI [1.1, 1.7], P < .001). The fertilization rate was also found to be significantly lower in the TESE-day-before group (45%) than in the TESE-day-of group (53%) (OR 1.4. 95% CI [1.2, 1.7], P = .01). Although the association between the cleavage rate and TESE timing was not statistically significant, the implantation rate was found to significantly higher in the day before cohort (28%) than in the day of cohort (22%) (OR 0.7. 95% CI [0.6, 0.9], P = .01). Nevertheless, it was found that the clinical pregnancy and delivery rates were not statistically significantly associated with the TESE timing. CONCLUSIONS: Although sperm retrieval and fertilization rates were lower in the TESE-day-before cohort, the two cohorts showed comparable embryologic and clinical outcomes. Micro-TESE can be performed before oocyte harvesting to provide physicians ample time to decide between cancelling oocyte retrieval or retrieving oocytes for cryopreservation.
