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. 2018 Jul;35(7):1229-1237.
doi: 10.1007/s10815-018-1178-5. Epub 2018 Apr 26.

Surgically acquired sperm use for assisted reproductive technology: trends and perinatal outcomes, USA, 2004-2015

Jennifer F Kawwass  1   2 , Jeani Chang  3 , Sheree L Boulet  3 , Ajay Nangia  4 , Akanksha Mehta  5   6 , Dmitry M Kissin  5   3
Affiliations

Surgically acquired sperm use for assisted reproductive technology: trends and perinatal outcomes, USA, 2004-2015

Jennifer F Kawwass et al. J Assist Reprod Genet. 2018 Jul.

Abstract

Purpose: To compare national trends and perinatal outcomes following the use of ejaculated versus surgically acquired sperm among IVF cycles with male factor infertility.

Methods: This retrospective cohort includes US fertility clinics reporting to the National ART Surveillance System between 2004 and 2015. Fresh, non-donor IVF male factor cycles (n = 369,426 cycles) were included. We report the following outcomes: (1) Trends in surgically acquired and ejaculated sperm. (2) Adjusted risk ratios comparing outcomes for intracytoplasmic sperm injection (ICSI) cycles using surgically acquired (epididymal or testicular) versus ejaculated sperm. (3) Outcomes per non-canceled cycle: biochemical pregnancy, intrauterine pregnancy, and live birth (≥ 20 weeks). (4) Outcomes per pregnancy: miscarriage (< 20 weeks) and singleton pregnancy. (5) Outcomes per singleton pregnancy: normal birthweight (≥ 2500 g) and full-term delivery (≥ 37 weeks).

Results: Percentage of male factor infertility cycles that used surgically acquired sperm increased over the study period, 9.8 (2004) to 11.6% (2015), p < 0.05. The proportion of cycles using testicular sperm increased significantly over the study period, 4.9 (2004) to 6.5% (2015), p < 0.05. Among fresh, non-donor male factor ART cycles which used ICSI (n = 347,078 cycles), cycle, pregnancy, and perinatal outcomes were statistically significant but clinically similar with confidence intervals approaching one between cycles involving epididymal versus ejaculated sperm and between testicular versus ejaculated sperm. Results were similar among cycles with a sole diagnosis of male factor (no female factors), and for the subset in which the female partner was < 35 years old.

Conclusion: Among couples undergoing ART for treatment of male factor infertility, pregnancy and perinatal outcomes were similar between cycles utilizing ejaculated sperm or surgically acquired testicular and epididymal sperm.

Keywords: IVF; PESA; Perinatal outcomes; TESE; Trends.

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Conflict of interest statement

The Centers for Disease Control and Prevention institutional review board approved this study.

ᅟ

Conflict of interest

The authors did not report any potential conflicts of interest. AM was supported by a research grant from the American Society for Reproductive Medicine.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Figures

Fig. 1
Fig. 1
Trends among fresh autologous IVF cycles with a male factor diagnosis—percentage of cycles with surgically acquired sperm, 2004–2015. *IVF in vitro fertilization, p < 0.05 for both epididymal and testicular sperm
See this image and copyright information in PMC

Comment in

  • Synergy at work: two heads are better than one.
    Jindal S, Sparks A. Jindal S, et al. J Assist Reprod Genet. 2018 Jul;35(7):1227-1228. doi: 10.1007/s10815-018-1250-1. Epub 2018 Jul 4. J Assist Reprod Genet. 2018. PMID: 29974371 Free PMC article. No abstract available.

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