A new method to process testicular sperm: combining enzymatic digestion, accumulation of spermatozoa, and stimulation of motility

Abstract

Purpose: In azoospermia processing of the TESE material often results in a sample of reduced purity. This prospective study was set up to clarify whether a combination of enzymatic digestion, density gradient centrifugation and stimulation of motility (where indicated) is a feasible option in TESE patients.

Methods: A total of 63 samples (showing spermatozoa) were processed by the present tripartite processing method. The resulting sperm sample of high purity was directly used for ICSI and subsequent cryopreservation when quality of the accumulated sperm sample allowed for it (n = 39 cycles).

Results: Compared to the control group blastocyst formation rate in the present tripartite processing technique was significantly (P < 0.01) higher (55.2 vs. 43.7%). Fertilization rates differed significantly (P < 0.001) between cases in which motile sperm could be used (58.4%) compared to ICSI with immotile sperm (45.0%). Clinical pregnancy rate per transfer was 40.0% (24/60) using fresh and 21.6% (8/37) with cryopreserved TESE material. The calculated live birth rates were 31.7 and 21.6%, respectively. Thirty-five healthy children were born.

Conclusions: A comparison with a control group suggests that the present approach using standardized ready-to-use products is efficient and reliable. Presumably healthy live births further indicate the safety of the procedure.