Retrieved Sperm No Better Than Ejaculated Sperm

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ATLANTA—Sperm retrieved from the testicles of men with severe oligoasthenospermia (OATS) is no better than their ejaculated sperm in achieving successful pregnancies, according to researchers at the Medical College of Wisconsin in Milwaukee.

“On the basis of what the literature has shown there is controversy which is the best sperm source, whether it is testicular or ejaculated sperm. We found there was really no difference between the two sources,” said lead investigator Anand Shridharani, MD, a urology resident.

Dr. Shridharani and his colleagues reviewed data on patients undergoing intracytoplasmic sperm injection (ICSI) for severe OATS between August 2003 and December 2008 at their institution. The researchers defined severe OATS as fewer than 0.2 million motile ejaculated sperm per specimen. The investigators compared the fertilization, clinical pregnancy, and live delivery rates of these couples to couples using testicular sperm from men with non-obstructive azoospermia (NOA).

Clinical follow-up and pregnancy data were available for eight patients with NOA and for 42 patients with severe OATS. There were a total of 19 pregnancies and 17 deliveries with a pregnancy rate per couple of 48%.The NOA patients underwent 11 oocyte retrievals with a fertilization rate of 56%. These patients also had eight pregnancies and seven deliveries with a pregnancy rate per couple of 62%. The 42 severe OATS patients underwent 60 retrievals and had a fertilization rate of 72%.

The findings, presented here at the annual meeting of the American Society of Reproductive Medicine, are good news “because it means if you have someone who has any sperm in their ejaculate at all, you can use their ejaculated sperm rather than performing a minimally-invasive, but still invasive procedure, to obtain testicular sperm,” said co-investigator Jay Sandlow, MD, Professor of Urology. 

Additionally, the findings suggest that cost savings are possible, Dr. Shridharani said. “We don't have the exact cost numbers but if you do use ejaculated sperm instead of testis sperm you obviate a procedure, which has some savings associated with it,” he said. “There are also the psychosocial aspects of undergoing a procedure, and the stress about undergoing a procedure on a sensitive area of the body.”

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