WASHINGTON U. – ST. LOUIS (US) — Couples struggling to conceive may benefit from using frozen sperm taken directly from the testicles.
“Men with no sperm in their semen now have more options to have children of their own,” says Randall Odem, professor of obstetrics and gynecology at Washington University in St. Louis.
Odem is coauthor of a recent study, published in PLOS ONE, that compared the success rates of in vitro fertilization (IVF) with frozen and fresh sperm.
“This study demonstrates that using frozen sperm taken by biopsy works as well for most patients in what matters most—pregnancy rates,” says Odem.
The findings may benefit men who don’t have enough sperm to have their own children through IVF without being biopsied.
A biopsy in a testicle often results in enough sperm to be used in a procedure called intracytoplasmic sperm injection (ICSI) as part of the IVF process.
The biopsy, which is usually performed on an outpatient basis, involves obtaining tissue from testicles that is examined for sperm. If sperm are found, they are removed and used immediately in ICSI or frozen for future use.
In ICSI, a single sperm is injected into an egg that has been surgically retrieved from a woman’s ovaries. The fertilized egg, or embryo, is then transferred to the woman’s womb.
“The convenience and ease of being able to use frozen sperm taken by biopsy in ICSI offers many advantages over fresh sperm,” says Kenan Omurtag, assistant professor of obstetrics and gynecology at Washington University in St. Louis.
When fresh sperm is used, the biopsy for the sperm retrieval needs to be done the day before or on the same day as egg retrieval from the woman. When frozen sperm is used, the man can have his biopsy first, and if sperm is found, it can be banked. Then, at the couple’s convenience, the woman’s eggs are retrieved and ICSI can be completed.
Before ICSI, a woman takes daily injections of fertility medications for a week to 10 days to stimulate her ovaries to produce eggs. Using an ultrasound to locate eggs, a doctor then removes them from the woman’s ovaries with a fine, hollow needle.
Researchers analyzed data from 1995 through 2009 from the Washington University Infertility and Reproductive Medicine Center.
One hundred thirty-six men had testicular biopsies to be used in ICSI. Of those biopsies, 84 percent involved frozen sperm and the remaining 16 percent used fresh sperm. A statistically significant difference in fertilization rate was noted between frozen sperm (62 percent) and fresh (47 percent) sperm, respectively.
Two urologists performed 150 testicular sperm biopsies in an operating room adjacent to the IVF lab, in an operating room in another building almost one mile from the IVF lab and in an ambulatory surgical center about 15 miles from the IVF lab. The maximum travel time from the third site was less than 30 minutes.
There was no statistically significant difference between the locations and pregnancy results.