Association of sperm source with miscarriage and take-home baby after ICSI in cryptozoospermia: a meta-analysis of testicular and ejaculated sperm

F.-Y. Ku, C.-C. Wu, Y.-W. Hsiao, Y.-N. Kang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Miscarriage and take-home baby are the most important issues to patients with cryptozoospermia in receiving intracytoplasmic sperm injection (ICSI). The ICSI usually use ejaculated or testicular sperm. Unfortunately, no synthesized evidence reported miscarriage and take-home baby rate between the two sperm sources. Objectives: This study aimed to compare the miscarriage and take-home baby rate of ICSI using testicular and ejaculated sperm in patient with cryptozoospermia. Materials and methods: We conducted meta-analyses that were based on data from Cochrane library, Ovid, PubMed, ScienceDirect, Scopus, and Web of Science. The pooled analyses used risk ratio (RR) in random-effects model. Sensitivity analyses by subgrouping were completed to explore the associations between mean age and outcome. Results: This study identified 331 potential citations and included four cohort studies for qualitative and quantitative synthesis. The four studies involved 331 patients with 479 ICSI cycles. The results showed no significant difference in miscarriage between testicular sperm group and ejaculated sperm group (RR = 1.06, 95% CI 0.48–2.35, p = 0.88). Yet, take-home babies per embryo transfer in testicular sperm group (53/226, 23.45%) was more than ejaculated sperm group (59/429, 13.75%) (RR = 1.72, 95% CI 1.21–2.44, p = 0.002). Similar results can be found in take-home babies per ICSI cycle (RR = 1.77, 95% CI 1.28–2.44, p = 0.0005), especially in younger couple (RR = 1.93, 95% CI 1.11–3.34, p = 0.02). No small study bias was detected in the analyses. Discussion: This study found that testicular sperm has more advantage for ICSI in patients with cryptozoospermia, especially in younger couple. These findings may help guide us when deciding the optimal method of sperm harvest for men with cryptozoospermia. Conclusion: Comparing to ejaculated sperm, testicular sperm showed benefits for take-home baby rate, but not for miscarriage in patients with cryptozoospermia. © 2018 American Society of Andrology and European Academy of Andrology
Original languageEnglish
JournalAndrology
DOIs
Publication statusPublished - 2018

Fingerprint

Intracytoplasmic Sperm Injections
Spontaneous Abortion
Meta-Analysis
Spermatozoa
Odds Ratio
Andrology
Embryo Transfer
PubMed
Libraries
Cohort Studies

Keywords

  • cryptozoospermia
  • ejaculated sperm
  • intracytoplasmic sperm injection
  • testicular sperm

Cite this

@article{569fd7a0c141428d84a999ea7ea0512b,
title = "Association of sperm source with miscarriage and take-home baby after ICSI in cryptozoospermia: a meta-analysis of testicular and ejaculated sperm",
abstract = "Background: Miscarriage and take-home baby are the most important issues to patients with cryptozoospermia in receiving intracytoplasmic sperm injection (ICSI). The ICSI usually use ejaculated or testicular sperm. Unfortunately, no synthesized evidence reported miscarriage and take-home baby rate between the two sperm sources. Objectives: This study aimed to compare the miscarriage and take-home baby rate of ICSI using testicular and ejaculated sperm in patient with cryptozoospermia. Materials and methods: We conducted meta-analyses that were based on data from Cochrane library, Ovid, PubMed, ScienceDirect, Scopus, and Web of Science. The pooled analyses used risk ratio (RR) in random-effects model. Sensitivity analyses by subgrouping were completed to explore the associations between mean age and outcome. Results: This study identified 331 potential citations and included four cohort studies for qualitative and quantitative synthesis. The four studies involved 331 patients with 479 ICSI cycles. The results showed no significant difference in miscarriage between testicular sperm group and ejaculated sperm group (RR = 1.06, 95{\%} CI 0.48–2.35, p = 0.88). Yet, take-home babies per embryo transfer in testicular sperm group (53/226, 23.45{\%}) was more than ejaculated sperm group (59/429, 13.75{\%}) (RR = 1.72, 95{\%} CI 1.21–2.44, p = 0.002). Similar results can be found in take-home babies per ICSI cycle (RR = 1.77, 95{\%} CI 1.28–2.44, p = 0.0005), especially in younger couple (RR = 1.93, 95{\%} CI 1.11–3.34, p = 0.02). No small study bias was detected in the analyses. Discussion: This study found that testicular sperm has more advantage for ICSI in patients with cryptozoospermia, especially in younger couple. These findings may help guide us when deciding the optimal method of sperm harvest for men with cryptozoospermia. Conclusion: Comparing to ejaculated sperm, testicular sperm showed benefits for take-home baby rate, but not for miscarriage in patients with cryptozoospermia. {\circledC} 2018 American Society of Andrology and European Academy of Andrology",
keywords = "cryptozoospermia, ejaculated sperm, intracytoplasmic sperm injection, testicular sperm",
author = "F.-Y. Ku and C.-C. Wu and Y.-W. Hsiao and Y.-N. Kang",
note = "Export Date: 11 November 2018 Article in Press Correspondence Address: Kang, Y.-N.; Center for Evidence-Based Medicine, Department of Education, Taipei Medical University HospitalTaiwan; email: academicnono@gmail.com References: Abhyankar, N., Kathrins, M., Niederberger, C., Use of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with cryptozoospermia: a meta-analysis (2016) Fertil Steril, 105, pp. 1469-1475. , &, e1461; Aitken, R.J., Krausz, C., Oxidative stress, DNA damage and the Y chromosome (2001) Reproduction (Cambridge, England), 122, pp. 497-506. , &; Amirjannati, N., Heidari-Vala, H., Akhondi, M.A., Hosseini Jadda, S.H., Kamali, K., Sadeghi, M.R., Comparison of intracytoplasmic sperm injection outcomes between spermatozoa retrieved from testicular biopsy and from ejaculation in cryptozoospermic men (2012) Andrologia, 44, pp. 704-709. , &; Ben-Ami, I., Raziel, A., Strassburger, D., Komarovsky, D., Ron-El, R., Friedler, S., Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men (2013) Fertil Steril, 99, pp. 1867-1871. , &; Bendikson, K.A., Neri, Q.V., Takeuchi, T., Toschi, M., Schlegel, P.N., Rosenwaks, Z., Palermo, G.D., The outcome of intracytoplasmic sperm injection using occasional spermatozoa in the ejaculate of men with spermatogenic failure (2008) J Urol, 180, pp. 1060-1064. , &; Cui, X., Ding, P., Gao, G., Zhang, Y., Comparison of the clinical outcomes of intracytoplasmic sperm injection between spermatozoa retrieved from testicular biopsy and from ejaculate in cryptozoospermia patients (2016) Urology, 102, pp. 106-110. , &; Esteves, S.C., Miyaoka, R., Orosz, J.E., Agarwal, A., An update on sperm retrieval techniques for azoospermic males (2013) Clinics, 68, pp. 99-110. , &; Esteves, S.C., S{\'a}nchez-Mart{\'i}n, F., S{\'a}nchez-Mart{\'i}n, P., Schneider, D.T., Gos{\'a}lvez, J., Comparison of reproductive outcome in oligozoospermic men with high sperm DNA fragmentation undergoing intracytoplasmic sperm injection with ejaculated and testicular sperm (2015) Fertil Steril, 104, pp. 1398-1405. , &; Esteves, S.C., Roque, M., Bradley, C.K., Garrido, N., Reproductive outcomes of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with high levels of DNA fragmentation in semen: systematic review and meta-analysis (2017) Fertil Steril, 108, pp. 456-467. , &, e451; Ghazzawi, I.M., Sarraf, M.G., Taher, M.R., Khalifa, F.A., Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection (1998) Hum Reprod, 13, pp. 348-352. , &; Hauser, R., Bibi, G., Yogev, L., Carmon, A., Azem, F., Botchan, A., Yavetz, H., Ben-Yosef, D., Virtual azoospermia and cryptozoospermia-fresh/frozen testicular or ejaculate sperm for better IVF outcome? (2011) J Androl, 32, pp. 484-490. , &; Henkel, R., Bastiaan, H.S., Schuller, S., Hoppe, I., Starker, W., Menkveld, R., Leucocytes and intrinsic ROS production may be factors compromising sperm chromatin condensation status (2010) Andrologia, 42, pp. 69-75. , &; Higgins, J.P., Thompson, S.G., Deeks, J.J., Altman, D.G., Measuring inconsistency in meta-analyses (2003) BMJ, 327, pp. 557-560. , &; Kang, Y.N., Hsiao, Y.W., Chen, C.Y., Wu, C.C., Testicular sperm is superior to ejaculated sperm for ICSI in cryptozoospermia: an update systematic review and meta-analysis (2018) Sci Rep, 8, p. 7874. , &; Ketabchi, A.A., Intracytoplasmic sperm injection outcomes with freshly ejaculated sperms and testicular or epididymal sperm extraction in patients with idiopathic cryptozoospermia (2016) Nephro-urology Monthly, 8; Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement (2009) Ann Intern Med, 151, pp. 264-269. , &, w264; Moskovtsev, S.I., Jarvi, K., Mullen, J.B., Cadesky, K.I., Hannam, T., Lo, K.C., Testicular spermatozoa have statistically significantly lower DNA damage compared with ejaculated spermatozoa in patients with unsuccessful oral antioxidant treatment (2010) Fertil Steril, 93, pp. 1142-1146. , &; Nakagawa, K., Ojiro, Y., Nishi, Y., Sugiyama, R., Motoyama, H., Sugiyama, R., Perinatal outcomes of patients who achieved pregnancy with a morphologically poor embryo via assisted reproductive technology (2016) Arch Gynecol Obstet, 293, pp. 183-188. , &; Shiva, M., Gautam, A.K., Verma, Y., Shivgotra, V., Doshi, H., Kumar, S., Association between sperm quality, oxidative stress, and seminal antioxidant activity (2011) Clin Biochem, 44, pp. 319-324. , &; Suganuma, R., Yanagimachi, R., Meistrich, M.L., Decline in fertility of mouse sperm with abnormal chromatin during epididymal passage as revealed by ICSI (2005) Human Reprod (Oxford, England), 20, pp. 3101-3108. , &; Weissman, A., Horowitz, E., Ravhon, A., Nahum, H., Golan, A., Levran, D., Pregnancies and live births following ICSI with testicular spermatozoa after repeated implantation failure using ejaculated spermatozoa (2008) Reproductive Biomed, 17, pp. 605-609. , &",
year = "2018",
doi = "10.1111/andr.12546",
language = "English",
journal = "Andrology",
issn = "2047-2919",
publisher = "Wiley-Blackwell Publishing Ltd",

}

TY - JOUR

T1 - Association of sperm source with miscarriage and take-home baby after ICSI in cryptozoospermia: a meta-analysis of testicular and ejaculated sperm

AU - Ku, F.-Y.

AU - Wu, C.-C.

AU - Hsiao, Y.-W.

AU - Kang, Y.-N.

N1 - Export Date: 11 November 2018 Article in Press Correspondence Address: Kang, Y.-N.; Center for Evidence-Based Medicine, Department of Education, Taipei Medical University HospitalTaiwan; email: academicnono@gmail.com References: Abhyankar, N., Kathrins, M., Niederberger, C., Use of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with cryptozoospermia: a meta-analysis (2016) Fertil Steril, 105, pp. 1469-1475. , &, e1461; Aitken, R.J., Krausz, C., Oxidative stress, DNA damage and the Y chromosome (2001) Reproduction (Cambridge, England), 122, pp. 497-506. , &; Amirjannati, N., Heidari-Vala, H., Akhondi, M.A., Hosseini Jadda, S.H., Kamali, K., Sadeghi, M.R., Comparison of intracytoplasmic sperm injection outcomes between spermatozoa retrieved from testicular biopsy and from ejaculation in cryptozoospermic men (2012) Andrologia, 44, pp. 704-709. , &; Ben-Ami, I., Raziel, A., Strassburger, D., Komarovsky, D., Ron-El, R., Friedler, S., Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men (2013) Fertil Steril, 99, pp. 1867-1871. , &; Bendikson, K.A., Neri, Q.V., Takeuchi, T., Toschi, M., Schlegel, P.N., Rosenwaks, Z., Palermo, G.D., The outcome of intracytoplasmic sperm injection using occasional spermatozoa in the ejaculate of men with spermatogenic failure (2008) J Urol, 180, pp. 1060-1064. , &; Cui, X., Ding, P., Gao, G., Zhang, Y., Comparison of the clinical outcomes of intracytoplasmic sperm injection between spermatozoa retrieved from testicular biopsy and from ejaculate in cryptozoospermia patients (2016) Urology, 102, pp. 106-110. , &; Esteves, S.C., Miyaoka, R., Orosz, J.E., Agarwal, A., An update on sperm retrieval techniques for azoospermic males (2013) Clinics, 68, pp. 99-110. , &; Esteves, S.C., Sánchez-Martín, F., Sánchez-Martín, P., Schneider, D.T., Gosálvez, J., Comparison of reproductive outcome in oligozoospermic men with high sperm DNA fragmentation undergoing intracytoplasmic sperm injection with ejaculated and testicular sperm (2015) Fertil Steril, 104, pp. 1398-1405. , &; Esteves, S.C., Roque, M., Bradley, C.K., Garrido, N., Reproductive outcomes of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with high levels of DNA fragmentation in semen: systematic review and meta-analysis (2017) Fertil Steril, 108, pp. 456-467. , &, e451; Ghazzawi, I.M., Sarraf, M.G., Taher, M.R., Khalifa, F.A., Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection (1998) Hum Reprod, 13, pp. 348-352. , &; Hauser, R., Bibi, G., Yogev, L., Carmon, A., Azem, F., Botchan, A., Yavetz, H., Ben-Yosef, D., Virtual azoospermia and cryptozoospermia-fresh/frozen testicular or ejaculate sperm for better IVF outcome? (2011) J Androl, 32, pp. 484-490. , &; Henkel, R., Bastiaan, H.S., Schuller, S., Hoppe, I., Starker, W., Menkveld, R., Leucocytes and intrinsic ROS production may be factors compromising sperm chromatin condensation status (2010) Andrologia, 42, pp. 69-75. , &; Higgins, J.P., Thompson, S.G., Deeks, J.J., Altman, D.G., Measuring inconsistency in meta-analyses (2003) BMJ, 327, pp. 557-560. , &; Kang, Y.N., Hsiao, Y.W., Chen, C.Y., Wu, C.C., Testicular sperm is superior to ejaculated sperm for ICSI in cryptozoospermia: an update systematic review and meta-analysis (2018) Sci Rep, 8, p. 7874. , &; Ketabchi, A.A., Intracytoplasmic sperm injection outcomes with freshly ejaculated sperms and testicular or epididymal sperm extraction in patients with idiopathic cryptozoospermia (2016) Nephro-urology Monthly, 8; Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement (2009) Ann Intern Med, 151, pp. 264-269. , &, w264; Moskovtsev, S.I., Jarvi, K., Mullen, J.B., Cadesky, K.I., Hannam, T., Lo, K.C., Testicular spermatozoa have statistically significantly lower DNA damage compared with ejaculated spermatozoa in patients with unsuccessful oral antioxidant treatment (2010) Fertil Steril, 93, pp. 1142-1146. , &; Nakagawa, K., Ojiro, Y., Nishi, Y., Sugiyama, R., Motoyama, H., Sugiyama, R., Perinatal outcomes of patients who achieved pregnancy with a morphologically poor embryo via assisted reproductive technology (2016) Arch Gynecol Obstet, 293, pp. 183-188. , &; Shiva, M., Gautam, A.K., Verma, Y., Shivgotra, V., Doshi, H., Kumar, S., Association between sperm quality, oxidative stress, and seminal antioxidant activity (2011) Clin Biochem, 44, pp. 319-324. , &; Suganuma, R., Yanagimachi, R., Meistrich, M.L., Decline in fertility of mouse sperm with abnormal chromatin during epididymal passage as revealed by ICSI (2005) Human Reprod (Oxford, England), 20, pp. 3101-3108. , &; Weissman, A., Horowitz, E., Ravhon, A., Nahum, H., Golan, A., Levran, D., Pregnancies and live births following ICSI with testicular spermatozoa after repeated implantation failure using ejaculated spermatozoa (2008) Reproductive Biomed, 17, pp. 605-609. , &

PY - 2018

Y1 - 2018

N2 - Background: Miscarriage and take-home baby are the most important issues to patients with cryptozoospermia in receiving intracytoplasmic sperm injection (ICSI). The ICSI usually use ejaculated or testicular sperm. Unfortunately, no synthesized evidence reported miscarriage and take-home baby rate between the two sperm sources. Objectives: This study aimed to compare the miscarriage and take-home baby rate of ICSI using testicular and ejaculated sperm in patient with cryptozoospermia. Materials and methods: We conducted meta-analyses that were based on data from Cochrane library, Ovid, PubMed, ScienceDirect, Scopus, and Web of Science. The pooled analyses used risk ratio (RR) in random-effects model. Sensitivity analyses by subgrouping were completed to explore the associations between mean age and outcome. Results: This study identified 331 potential citations and included four cohort studies for qualitative and quantitative synthesis. The four studies involved 331 patients with 479 ICSI cycles. The results showed no significant difference in miscarriage between testicular sperm group and ejaculated sperm group (RR = 1.06, 95% CI 0.48–2.35, p = 0.88). Yet, take-home babies per embryo transfer in testicular sperm group (53/226, 23.45%) was more than ejaculated sperm group (59/429, 13.75%) (RR = 1.72, 95% CI 1.21–2.44, p = 0.002). Similar results can be found in take-home babies per ICSI cycle (RR = 1.77, 95% CI 1.28–2.44, p = 0.0005), especially in younger couple (RR = 1.93, 95% CI 1.11–3.34, p = 0.02). No small study bias was detected in the analyses. Discussion: This study found that testicular sperm has more advantage for ICSI in patients with cryptozoospermia, especially in younger couple. These findings may help guide us when deciding the optimal method of sperm harvest for men with cryptozoospermia. Conclusion: Comparing to ejaculated sperm, testicular sperm showed benefits for take-home baby rate, but not for miscarriage in patients with cryptozoospermia. © 2018 American Society of Andrology and European Academy of Andrology

AB - Background: Miscarriage and take-home baby are the most important issues to patients with cryptozoospermia in receiving intracytoplasmic sperm injection (ICSI). The ICSI usually use ejaculated or testicular sperm. Unfortunately, no synthesized evidence reported miscarriage and take-home baby rate between the two sperm sources. Objectives: This study aimed to compare the miscarriage and take-home baby rate of ICSI using testicular and ejaculated sperm in patient with cryptozoospermia. Materials and methods: We conducted meta-analyses that were based on data from Cochrane library, Ovid, PubMed, ScienceDirect, Scopus, and Web of Science. The pooled analyses used risk ratio (RR) in random-effects model. Sensitivity analyses by subgrouping were completed to explore the associations between mean age and outcome. Results: This study identified 331 potential citations and included four cohort studies for qualitative and quantitative synthesis. The four studies involved 331 patients with 479 ICSI cycles. The results showed no significant difference in miscarriage between testicular sperm group and ejaculated sperm group (RR = 1.06, 95% CI 0.48–2.35, p = 0.88). Yet, take-home babies per embryo transfer in testicular sperm group (53/226, 23.45%) was more than ejaculated sperm group (59/429, 13.75%) (RR = 1.72, 95% CI 1.21–2.44, p = 0.002). Similar results can be found in take-home babies per ICSI cycle (RR = 1.77, 95% CI 1.28–2.44, p = 0.0005), especially in younger couple (RR = 1.93, 95% CI 1.11–3.34, p = 0.02). No small study bias was detected in the analyses. Discussion: This study found that testicular sperm has more advantage for ICSI in patients with cryptozoospermia, especially in younger couple. These findings may help guide us when deciding the optimal method of sperm harvest for men with cryptozoospermia. Conclusion: Comparing to ejaculated sperm, testicular sperm showed benefits for take-home baby rate, but not for miscarriage in patients with cryptozoospermia. © 2018 American Society of Andrology and European Academy of Andrology

KW - cryptozoospermia

KW - ejaculated sperm

KW - intracytoplasmic sperm injection

KW - testicular sperm

U2 - 10.1111/andr.12546

DO - 10.1111/andr.12546

M3 - Article

JO - Andrology

JF - Andrology

SN - 2047-2919

ER -