Obstet Gynecol Sci.  2019 Nov;62(6):429-437. 10.5468/ogs.2019.62.6.429.

ICSI using fresh and frozen PESA-TESA spermatozoa to examine assisted reproductive outcome retrospectively

• Javed A
• Ramaiah MK
• Talkad MS

• KMID: 2462121
• DOI: http://doi.org/10.5468/ogs.2019.62.6.429

Abstract

OBJECTIVE
The male reproductive system generates, accumulates, and transports the sperm. In this study, 2 methods of surgically retrieving sperm, namely, testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA), are discussed and studied in men aged ≤38 years to achieve successful conception using assisted reproductive technology. The purpose was to assess the fertilization rate (FA), clinical pregnancy, and live birth rate (LBR) with sperm.
METHODS
A total of 287 semen samples were divided into 4 groups as follows: fresh PESA (n=73), frozen PESA (n=65), fresh TESA (n=128), and frozen TESA (n=21). The DNA fragmentation test using sperm chromatin dispersion assay was measured and reported.
RESULTS
FA was 70.3% and 65.5%, (P<0.022) for fresh and frozen epididymal sperm and 53.8% and 49.5%, (P<0.032) for fresh and frozen testicular sperm. LBR was 33.6% and 30.2% (P<0.075) for fresh and frozen epididymal sperm (PESA) and 22.7% and 18.2% (P<0.063) for fresh and frozen-thawed TESA sperm.
CONCLUSION
Exposure to tissue shearing may adversely affect sperm quality. Increased sperm DNA damage due to long-term exposure while teasing enhances reactive oxygen species production foremost to membrane damage because of the oxidation of polyunsaturated fatty acid in lipids (lipid peroxidation), oxidation of amino acid in proteins, and inactivation of specific enzymes, all leading to enzymatic dipping and possibility of less fertilization and conception as indicated by the increase in LBR with fresh/frozen PESA compared to with fresh/frozen TESA.

Keyword

Spermatozoa; Fertilization; Infertility; DNA fragmentation

MeSH Terms

Chromatin
DNA Damage
DNA Fragmentation
Fertilization
Humans
Infertility
Live Birth
Male
Membranes
Pregnancy
Reactive Oxygen Species
Reproductive Techniques, Assisted
Retrospective Studies*
Semen
Sperm Injections, Intracytoplasmic*
Sperm Retrieval
Spermatozoa*
Chromatin
Reactive Oxygen Species

Figure

• 

  Fig. 1 Sperm chromatin dispersion (SCD) test % on testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA) sperms.Data presented as dispersed and non dispersed nuclei mean percentage for the 4 independent observations, dispersed and non-dispersed percentage for fresh PESA (63.76–36.23), dispersed and non-dispersed percentage for frozen PESA (56.99–43), dispersed and non-dispersed percentage for fresh TESA (62–38) and dispersed and non-dispersed percentage for frozen TESA (67.18–32.81) and number of observation in fresh PESA=73, frozen PESA=65, fresh TESA=128, and frozen TESA=21.

• 

  Fig. 2 Pregnancy outcomes: testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA). Data presented as positive B-hCG (+βhcg) and clinical pregnancy rate (CPR) mean percentage for the 4 independent observations, +βhcg and CPR & live birth rate (LBR) and miscarriage rate (MR) for fresh PESA (39.6–36.5) & (33.6–2.9), frozen PESA (36.5–34.6) & (30.2–4.4), fresh TESA (33.7–29.2) & (22.7–6.5) and frozen TESA (26.8–24.3) & (18.2–6.1).

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