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Journal of Assisted Reproduction and Genetics

Published in:

01-07-2018 | Assisted Reproduction Technologies

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

Authors: Jennifer F. Kawwass, Jeani Chang, Sheree L. Boulet, Ajay Nangia, Akanksha Mehta, Dmitry M. Kissin

Published in: Journal of Assisted Reproduction and Genetics | Issue 7/2018

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.

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Title: Surgically acquired sperm use for assisted reproductive technology: trends and perinatal outcomes, USA, 2004–2015
Authors: Jennifer F. Kawwass
Jeani Chang
Sheree L. Boulet
Ajay Nangia
Akanksha Mehta
Dmitry M. Kissin
Publication date: 01-07-2018
Publisher: Springer US
Published in: Journal of Assisted Reproduction and Genetics / Issue 7/2018
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-018-1178-5

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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