Levels of sperm DNA fragmentation: systematic review and meta-analysis Dr Sandro Esteves
Channel: Dr. Julio Voget
Date: 2017-07-12

ESHRE - 2017 GENEVA SWITZERLAND 
Reproductive outcomes of testicular versus ejaculated sperm for intracytoplasmic sperm injection among men with high levels of sperm DNA fragmentation: systematic review and meta-analysis.

S. Esteves1, M. Roque2, N. Garrido3.
1ANDROFERT, Center for Male Reproduction, Campinas, Brazil. 2ORIGEN, Center for Reproductive Medicine, Rio de Janeiro, Brazil. 3IVI Foundation, Andrology, Valencia, Spain.
Study question:
To assess outcomes of intracytoplasmic sperm injection (ICSI) using testicular compared with ejaculated sperm in men with high sperm DNA fragmentation.
Summary answer:
The existing evidence supports the use of testicular sperm in preference over ejaculated sperm for ICSI in men with high sperm DNA fragmentation (SDF).
What is known already:
Recent studies have suggested potential benefits of using testicular versus ejaculated sperm for ICSI among couples with repeated ICSI failure. Oxidative- induced SDF during epididymis transit has been postulated to lower ejaculate sperm quality that may negatively impact ICSI outcomes. However, the evidence is not unequivocal, and some studies have found no benefit of testicular versus ejaculated sperm among men with cryptozoospermia. Therefore, we sought to assess the available evidence concerning outcomes of ICSI using testicular versus ejaculated sperm among infertile men with a strong rationale for using testicular sperm, namely, those with confirmed post-testicular sperm DNA fragmentation.