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37A - Testicular Sperm Should Be Considered for Repeated ICSI Failed Implantation Cases in Men with High Sperm DNA Damage

For

from Section VI - Male-factor Infertility

Published online by Cambridge University Press:  25 November 2021

By
Lesley Haddock  and
Sheena EM Lewis
Edited by
Roy Homburg ,
Adam H. Balen  and
Robert F. Casper
Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

For couples with repeated ICSI failure, there is currently no further treatment option for men wishing to father their own biological child. Men with high damage in their ejaculated sperm have less DNA damage in their testicular and epididymal sperm. Live birth rates are higher in Testi-ICSI than conventional ICSI for couples with repeated ICSI failure, and PICSI and IMSI are less successful than Testi-ISCI. ICSI with testicular sperm should NOT be offered to men with untested sperm DNA as evidence of benefit is ambivalent. In order to ensure that testicular sperm are indeed of better genomic quality than their ejaculate counterparts, diagnostic testing is required to avoid invasive biopsy unless indicated. Prior to Testi-ICSI, men should have clinical histories and examinations and all other causes of sperm DNA damage should be treated. A major confounding factor in assessing the benefits of Testi-ICSI with conventional ICSI is female age.

Type
Chapter
Information
50 Big Debates in Reproductive Medicine , pp. 189 - 190
Publisher: Cambridge University Press
Print publication year: 2021

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References

Simon, L, Emery, BR, Carrell, DT, et al. Review: Diagnosis and impact of sperm DNA alterations in assisted reproduction. Best Pract Res Clin Obstet. 2017;44:38–56.CrossRefGoogle ScholarPubMed
Bradley, CK, McArthur, SJ, Gee, AJ, et al. Intervention improves assisted conception intracytoplasmic sperm injection outcomes for patients with high levels of sperm DNA fragmentation: a retrospective analysis. Andrology. 2016;4:903–10.CrossRefGoogle ScholarPubMed
Esteves, SC, Roque, M, Bradley, CK, Carrido, 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. Fertil Steril. 2017;108:456–67.CrossRefGoogle ScholarPubMed
Ribas-Maynou, J, Benet, J. Single and double strand sperm DNA damage: different reproductive effects on male fertility. Genes. 2019;10(2):105.CrossRefGoogle ScholarPubMed
Kumar, K, Lewis, S, Vinci, S, et al. Evaluation of sperm DNA quality in men presenting with testicular cancer and lymphoma using alkaline and neutral Comet assays. Andrology. 2018 Jan;6(1):230–5.CrossRefGoogle ScholarPubMed

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