Surgically Extracted Epididymal Sperm from Men with Obstructive Azoospermia Results in Similar In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes Compared with Normal Ejaculated Sperm

No AccessJournal of UrologyAdult Urology1 Feb 2021Surgically Extracted Epididymal Sperm from Men with Obstructive Azoospermia Results in Similar In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes Compared with Normal Ejaculated SpermThis article is commented on by the following:Editorial CommentEditorial Comment Solomon Hayon, Sarah Moustafa, Caitlin Boylan, Taylor P. Kohn, Mary Peavey, and R. Matthew Coward Solomon HayonSolomon Hayon *Correspondence: Department of Urology, University of North Carolina School of Medicine, 2113 Physicians Office Bldg., 170 Manning Dr., Chapel Hill, North Carolina 27599-7235 telephone: 984-974-0404; FAX: 984-974-5289; E-mail Address: [email protected] Department of Urology, University of North Carolina School of Medicine, Chapel Hill, North Carolina More articles by this author , Sarah MoustafaSarah Moustafa Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author , Caitlin BoylanCaitlin Boylan UNC Fertility, Raleigh, North Carolina More articles by this author , Taylor P. KohnTaylor P. Kohn The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author , Mary PeaveyMary Peavey Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author , and R. Matthew CowardR. Matthew Coward Department of Urology, University of North Carolina School of Medicine, Chapel Hill, North Carolina Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001388AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Controversy exists around the use of epididymal sperm for in vitro fertilization and intracytoplasmic sperm injection for couples with obstructive azoospermia, and the ability to reliably predict fertility outcomes with surgically extracted epididymal sperm remains limited. To provide additional clinical context, we sought to compare in vitro fertilization/intracytoplasmic sperm injection outcomes of epididymal sperm from couples with obstructive azoospermia to outcomes of couples using normal, ejaculated sperm. Materials and Methods: We performed a case-control analysis of 40 couples who underwent office based epididymal sperm retrieval for obstructive azoospermia followed by in vitro fertilization/intracytoplasmic sperm injection compared with a control group of 38 female, age matched couples with no evidence of female factor infertility who underwent in vitro fertilization/intracytoplasmic sperm injection with normal, ejaculated sperm. Primary outcome was live birth on the initial embryo transfer. Results: Epididymal samples yielded a median total motile sperm count of 9.1 million, compared to 81 million for ejaculated sperm. On the primary embryo transfer fertilization rate (71% vs 77%, p=0.2), blastulation rate (48% vs 59%, p=0.09), clinical pregnancy rate (70% vs 58%, p=0.4), and live birth rate (58% vs 47%, p=0.4) did not differ between epididymal and ejaculated sperm groups. Conclusions: For couples with a male partner with obstructive azoospermia epididymal sperm in vitro fertilization/intracytoplasmic sperm injection outcomes compare similarly with age matched controls undergoing in vitro fertilization/intracytoplasmic sperm injection using normal, ejaculated sperm. These results may help reproductive surgeons provide reassurance about the use of obstructed epididymal sperm as well as help guide discussions about anticipated outcomes of in vitro fertilization/intracytoplasmic sperm injection. 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Hansen assisted with the study.MetricsAuthor Information Solomon Hayon Department of Urology, University of North Carolina School of Medicine, Chapel Hill, North Carolina *Correspondence: Department of Urology, University of North Carolina School of Medicine, 2113 Physicians Office Bldg., 170 Manning Dr., Chapel Hill, North Carolina 27599-7235 telephone: 984-974-0404; FAX: 984-974-5289; E-mail Address: [email protected] More articles by this author Sarah Moustafa Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author Caitlin Boylan UNC Fertility, Raleigh, North Carolina More articles by this author Taylor P. Kohn The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author Mary Peavey Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author R. Matthew Coward Department of Urology, University of North Carolina School of Medicine, Chapel Hill, North Carolina Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina UNC Fertility, Raleigh, North Carolina More articles by this author Expand All Supported by Grant 2015213 from the Doris Duke Charitable Foundation. Advertisement PDF DownloadLoading ...