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    • COMPARING EUPLOIDY IN TESE, MESA, AND EJACULATE FROM PATIENTS WITH AND WITHOUT MALE FACTOR INFERTILITY.

    Isaac J. Chamani,David H. McCulloh,Bobby B. Najari,Frederick L. Licciardi

    FERTILITY AND STERILITY（2020）

    NYU Sch Med

    Cited 0|Views16
    Abstract
    Sperm retrieval via testicular sperm extraction (TESE) or microsurgical epididymal sperm aspiration (MESA) have been used to treat men with obstructive and non-obstructive azoospermia. Here we compare fertilization rates, blastocyst formation, euploidy, and euploidy rates, in IVF cycles with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A), with sperm obtained via TESE, MESA and ejaculation. Retrospective cohort. Patients who underwent IVF or embryo banking with ICSI and PGT-A at NYU Fertility Center from 2/1/15 to 3/31/19, were separated into four groups for comparison based on the method of sperm procurement: TESE, MESA, ejaculate of males with male factor infertility (initial motility < 40% and/or count < 20 M/ml) (Ejac+MF), and ejaculate of males without male factor infertility (Ejac-MF). Demographics, total IUs gonadotropin received, trigger-day estrogen levels, number of oocytes retrieved, number of mature oocytes, fertilization rates, number of blastocysts formed, number of euploid embryos formed, and euploidy rates, were compared by performing a one-way ANOVA using 0.05 as the alpha level, and a posteriori testing. Altogether, 283 patients were compared in the four groups: 56 TESE patients, 5 MESA patients, 160 Ejac+MF patients, and 62 Ejac-MF patients. There were no significant differences in maternal age, total IUs gonadotropin received, trigger-day estrogen levels, number of oocytes retrieved, or number of mature oocytes, between all four groups. TESE patients had significantly lower fertilization rates, blastocyst formation, and euploid embryos (64%, 3.7, 1.1, respectively) than both Ejac+MF (73%, 4.7, 1.4, respectively) and Ejac-MF (78%, 5.8, 2.1, respectively). The euploidy rates (euploid embryos/number of blastocyts) were not significantly different between the three groups (TeSE 23%, Ejac+MF 27%, Ejac-MF 30%). Finally, Ejac+MF patients had a significantly lower number of euploid embryos (1.4) that Ejac-MF patients (2.1). In patients undergoing IVF with ICSI and PGT-A, significantly lower fertilization rates, and numbers of blastocysts and euploid embryos, were found when comparing TESE to Ejac+MF and Ejac-MF. However, the euploidy rates were not significantly different, suggesting that the number of embryos formed is the point of distinction. Ejac+MF patients also produced a smaller number of euploid embryos, than Ejac-MF patients.
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