Fertilization and embryo development with spermatozoa obtained from testicular sperm extraction into oocytes generated from human chorionic gonadotropin primed in vitro maturation cycles

Capsule:
The fertilization rate and embryo development of IVM oocytes after intracytoplasmic sperm injection (ICSI) using testicular spermatozoa was lower than that of sibling in vivo-matured oocytes.

Authors:
Weon-Young Son, Ph.D., Jin-Tae Chung, M.S., Sara Henderson, B.S., Shauna Reinblatt, M.D., William Buckett, M.D., Peter T.K. Chan, M.D., Hananel Holzer, M.D.

Volume 100, Issue 4, Pages 989-993, October 2013

Abstract:

Objective:
To evaluate the fertilization rate and embryo development resulting from intracytoplasmic sperm injection (ICSI) of spermatozoa retrieved by testicular sperm extraction (TESE) in hCG-primed in vitro maturation (IVM) cycles.

Design:
Case-control study.

Setting:
University teaching hospital.

Patient(s):
Twenty-four IVM cycles were performed in 21 patients (mean age, 32.3 ± 2.4 years) with polycystic ovaries (PCO) whose partners were nonobstructive azoospermic. Twelve cycles where IVM oocytes were also retrieved were compared with a control group consisting of age-matched IVM cycles with ICSI using ejaculated spermatozoa (n = 12).

Intervention(s):
In vitro maturation treatment with TESE sperm.

Main Outcome Measure(s):
Fertilization and embryo development between sibling oocytes matured in vivo and in vitro.

Result(s):
Eight singleton pregnancies and one twin pregnancy were obtained after ET (9/24, 37.5%). In the 12 IVM cycles where in vivo-matured oocytes were also obtained, the fertilization rate after TESE-ICSI was significantly higher in in vivo-matured oocytes than in sibling in vitro-matured oocytes (84.2% vs. 53.2%). The proportion of good quality embryos was also higher (63.5% vs. 40.2%). In the control group of cycles with ejaculated spermatozoa, there was no difference in fertilization rates between sibling oocytes matured in vivo and in vitro (84.6% vs. 79.6%).

Conclusion(s):
Our results suggest that IVM of immature oocytes combined with TESE-ICSI is an option for couples with PCO and azoospermia. However, there are lower fertilization and good quality embryo rates achieved when TESE-ICSI was done with in vitro-matured oocytes. Additional studies are necessary to determine the role of this treatment combination.

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