Neonatal outcome of children born after ICSI with epididymal or testicular sperm: A 10-year study in China

Lei Jin, Zhou Li, Longjie Gu, Bo Huang, Lei Jin, Zhou Li, Longjie Gu, Bo Huang

Abstract

Some studies show that children born after ICSI with non-ejaculated sperm are at increased risk of birth defects, other studies hold the opposite view. Does neonatal outcome including congenital malformations in children born after ICSI with percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA) differ from neonatal outcome in children born after ICSI with ejaculated sperm? In this study, we examined the data from our IVF center from 2006 to 2016, to compare neonatal outcomes and rates of congenital malformations in children born after ICSI with different sperm origin. The results showed the clinical pregnancy rate and implantation rate of non-ejaculated sperm group were significantly higher (P < 0.001) than ejaculated sperm group. There were 775 clinical pregnancies from non-ejaculated sperm group and 2,486 clinical pregnancies from ejaculated sperm group. Most of the clinical pregnancy outcomes were comparable between non-ejaculated sperm group and ejaculated sperm group (p > 0.05): the miscarriage rate per transfer, ectopic pregnancy rate per clinical pregnancy, induced abortion rate per clinical pregnancy and fetal deaths per clinical pregnancy. However, the live delivery rate per transfer of non-ejaculated sperm group was significantly higher than that of ejaculated sperm group (45.4% vs 36.7%, P < 0.001). Moreover, the comparison between the epididymal sperm, testicular sperm and ejaculated sperm groups showed there were no difference in the incidence of congenital malformations of babies live birth. Among singleton gestation live births, there were more girls than boys in both non-ejaculated sperm and ejaculated sperm group. In conclusion, the present study clearly showed no statistical increased risk in neonatal outcomes of newborns were found in the ICSI treatment with epididymal or testicular sperm. It may provide information for consultation for ICSI treatment in PESA or TESA patients.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The flow chart of the study design.

References

    1. Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet. 1978;2:366–366. doi: 10.1016/S0140-6736(78)92957-4.
    1. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340:17–18. doi: 10.1016/0140-6736(92)92425-F.
    1. Irvine DS. Epidemiology and aetiology of male infertility. Hum. Reprod. 1998;13(Suppl 1):33–44. doi: 10.1093/humrep/13.suppl_1.33.
    1. De Croo I, der Elst V, Everaert J, De Sutter K, Dhont P. M. Fertilization, pregnancy and embryo implantation rates after ICSI in cases of obstructive and non-obstructive azoospermia. Hum. Reprod. 2000;15:1383–1388. doi: 10.1093/humrep/15.6.1383.
    1. Dozortsev D, et al. Embryos generated using testicular spermatozoa have higher developmental potential than those obtained using epididymal spermatozoa in men with obstructive azoospermia. Fertil. Steril. 2006;86:606–611. doi: 10.1016/j.fertnstert.2006.01.036.
    1. Kamal A, et al. Does the outcome of ICSI in cases of obstructive azoospermia depend on the origin of the retrieved spermatozoa or the cause of obstruction? A comparative analysis. Fertil. Steril. 2010;94:2135–2140. doi: 10.1016/j.fertnstert.2010.01.041.
    1. Tournaye, H. et al. Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection: a new effective approach to infertility as a result of congenital bilateral absence of the vas deferens. Fertil Steril61, 1045-1051, doi:S0015-0282(16)56754-5[pii] (1994).
    1. Devroey, P. et al. Normal fertilization of human oocytes after testicular sperm extraction and intracytoplasmic sperm injection. Fertil Steril62, 639-641, doi:S0015-0282(16)56958-1[pii] (1994).
    1. Nagy Z, et al. Using ejaculated, fresh, and frozen-thawed epididymal and testicular spermatozoa gives rise to comparable results after intracytoplasmic sperm injection. Fertil. Steril. 1995;63:808–815. doi: 10.1016/S0015-0282(16)57486-X.
    1. Woldringh GH, Besselink DE, Tillema AH, Hendriks JC, Kremer JA. Karyotyping, congenital anomalies and follow-up of children after intracytoplasmic sperm injection with non-ejaculated sperm: a systematic review. Hum. Reprod. Update. 2010;16:12–19. doi: 10.1093/humupd/dmp030dmp030[pii].
    1. Oldereid NB, et al. Pregnancy outcome according to male diagnosis after ICSI with non-ejaculated sperm compared with ejaculated sperm controls. Reprod. Biomed. Online. 2014;29:417–423. doi: 10.1016/j.rbmo.2014.06.009S1472-6483(14)00358-7[pii].
    1. Belva F, et al. Neonatal outcome of 724 children born after ICSI using non-ejaculated sperm. Hum. Reprod. 2011;26:1752–1758. doi: 10.1093/humrep/der121.
    1. Woldringh GH, et al. Follow-up of children born after ICSI with epididymal spermatozoa. Hum. Reprod. 2011;26:1759–1767. doi: 10.1093/humrep/der136.
    1. Fedder J, Loft A, Parner ET, Rasmussen S, Pinborg A. Neonatal outcome and congenital malformations in children born after ICSI with testicular or epididymal sperm: a controlled national cohort study. Hum. Reprod. 2013;28:230–240. doi: 10.1093/humrep/des377des377[pii].
    1. Huang, B. et al. Neonatal outcomes after early rescue intracytoplasmic sperm injection: an analysis of a 5-year period. Fertil Steril103, 1432-1437 e1431, doi:10.1016/j.fertnstert.2015.02.026S0015-0282(15)00156-9[pii] (2015).
    1. Huang Bo, Hu Dan, Qian Kun, Ai Jihui, Li Yufeng, Jin Lei, Zhu Guijin, Zhang Hanwang. Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles. Fertility and Sterility. 2014;102(5):1345–1349. doi: 10.1016/j.fertnstert.2014.07.1245.
    1. Wennerholm UB, et al. Obstetric outcome of pregnancies following ICSI, classified according to sperm origin and quality. Hum. Reprod. 2000;15:1189–1194. doi: 10.1093/humrep/15.5.1189.
    1. Ludwig M, Katalinic A. Pregnancy course and health of children born after ICSI depending on parameters of male factor infertility. Hum. Reprod. 2003;18:351–357. doi: 10.1093/humrep/deg048.
    1. Tsai CC, et al. Clinical outcomes and development of children born after intracytoplasmic sperm injection (ICSI) using extracted testicular sperm or ejaculated extreme severe oligo-astheno-teratozoospermia sperm: a comparative study. Fertil. Steril. 2011;96:567–571. doi: 10.1016/j.fertnstert.2011.06.080S0015-0282(11)01106-X[pii].
    1. Bonduelle M, et al. Neonatal data on a cohort of 2889 infants born after ICSI (1991-1999) and of 2995 infants born after IVF (1983-1999) Hum. Reprod. 2002;17:671–694. doi: 10.1093/humrep/17.3.671.
    1. Sutcliffe, A. G. & Ludwig, M. Outcome of assisted reproduction. Lancet370, 351-359, doi:S0140-6736(07)60456-5[pii]10.1016/S0140-6736(07)60456-5 (2007).
    1. Lie, R. T. et al. Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods; a meta-analysis. Int J Epidemiol34, 696-701, doi:dyh363 [pii]10.1093/ije/dyh363 (2005).
    1. Kallen B, et al. Congenital malformations in infants born after in vitro fertilization in Sweden. Birth Defects Res. A Clin. Mol. Teratol. 2010;88:137–143. doi: 10.1002/bdra.20645.
    1. Fedder, J. et al. Malformation rate and sex ratio in 412 children conceived with epididymal or testicular sperm. Hum Reprod22, 1080-1085, doi:del488[pii]10.1093/humrep/del488 (2007).
    1. Gianaroli, L. et al. Frequency of aneuploidy in sperm from patients with extremely severe male factor infertility. Hum Reprod20, 2140-2152, doi:dei033[pii]10.1093/humrep/dei033 (2005).
    1. Holte, T. O. et al. Male infertility: intracytoplasmic sperm injection (ICSI) using surgically retrieved sperm from the testis or the epididymis. Report from NOKC, Health technology assessment (HTA)nr 07 (2007).
    1. Rui-na DONG Y-hG, Ying-pu SUN, Ying-chun SU, Jing LI. Clinical Outcome Analysis of 3,106 Intracytoplasmic Sperm Injection Cycles Using Spermatozoa of Different Origin. Reproduction &. Contraception. 2013;33:233–238. doi: 10.7669/j.issn.0253-357X.2013.04.0233.
    1. Youmiao Tang XW, Lou H, Qiao Y, Du M. Early Clinical Outcomes of ICSI with Sperm from Different Sources. Med. Innov. China. 2018;15:022–025.
    1. Greco E, et al. Efficient treatment of infertility due to sperm DNA damage by ICSI with testicular spermatozoa. Hum. Reprod. 2005;20:226–230. doi: 10.1093/humrep/deh590.
    1. Palermo, G. D., Neri, Q. V., Schlegel, P. N. & Rosenwaks, Z. Intracytoplasmic Sperm Injection (ICSI) in Extreme Cases of Male Infertility. PLoS One9, doi:ARTNe11367110.1371/journal.pone.0113671 (2014).
    1. Esteves SC, Roque M, Bradley CK, Garrido N. Reproductive outcomes of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with high levels of DNA fragmentation in semen: systematic review and meta-analysis. Fertil. Steril. 2017;108:456-+. doi: 10.1016/j.fertnstert.2017.06.018.

Source: PubMed

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