Testicular versus ejaculated sperm should be used for intracytoplasmic sperm injection (ICSI) in cases of infertility associated with sperm DNA fragmentation | Opinion: Yes

Vol. 44 (4): 667-675, July – August, 2018

doi: 10.1590/S1677-5538.IBJU.2018.04.03


DIFFERENCE OF OPINION

Sandro C. Esteves 1,2,3
1 ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, SP, Brasil; 2 Departamento de Cirurgia (Disciplina de Urologia), Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, SP, Brasil; 3 Faculty of Health, Aarhus University, 8000 Aarhus C, Denmark

Keywords: Semen; Infertility, Male; Sperm Injections, Intracytoplasmic; Sperm DNA Fragmenttion; Testicular Sperm


The use of testicular in preference over ejaculated sperm for intracytoplasmic sperm injection (ICSI) has gained increased attention due to reports of better pregnancy outcomes using testicular sperm for cases of infertility associated with high sperm DNA fragmentation (SDF) (reviewed by Esteves et al. (1)). Indeed, it has been a common practice to perform testicular sperm retrieval for ICSI (Testi-ICSI) in selected groups of non-azoospermic men. In a recent survey study involving infertility experts from 19 countries, 67% responders admitted that na abnormal SDF test result would affect their decision to utilize testicular instead of ejaculated sperm for ICSI (2). Interestingly, identical numbers were reported by attendees of an interactive debate session held during the 2017 annual meeting of the American Society for Reproductive Medicine (unpublished data).

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