P–122 Benefit of use of theophilline in ICSI with testicular sperm
Authors: Be. Khelif. Jerbi M , Chabchoub I , Sfaxi S , Be. aribia M H , Mnallah S , Khrouf M , Terras K , Zhioua F , Mahmoud K , Elloumi H 
Published: August 2021

Abstract

Study question
Would the use of theophylline have an effect on ICSI outcomes?

Summary answer
The cumulative pregnancy rate after the transfer of fresh and frozen embryos (FET) becomes more important justifying the addition of theophylline as an efficacy variable.

What is known already
Absolute immotile spermatozoa is one of the most important causes of reduced fertilization and pregnancy rates after ICSI, immotility of testicular spermatozoa is a physiological event resulting from metabolic sperm immaturity. Over the years, there have been numerous attempts to resolve this problem by identification of pharmacological agents that might improve sperm motility. In particular, theophylline turned out to be an effective tool in stimulating motility in human semen and identifying viable sperm in testicular sperm extraction sperm (TESE) patients. aim of this study is to evaluate ICSI outcomes after the use of theophylline to select viable spermatozoa

Study design, size, duration
This prospective, comparative randomised study was conducted in Fertillia ART center in Tunisia, between november 2017 to november 2020. All patients underwent ICSI cycles with testicular sperm were included. The exclusion criteria consist of cycles with female partner age &gt;42 years and/or cycles with no information about pregnancy outcomes. In our study, the cycles were categorized into two groups according to sperm selection method used in ICSI procdure.

Participants/materials, setting, methods
The present study include 678 cycles. This cohort was randomly divided into two groups according to method of spermatozoa selection. Treatements arms were performed by theophylline to improve sperm motility (Group A) and the Hyposmotic swelling (HOS) test to indicate sperm vitality (Group B). Clinical and biological parameters, the duration of sperm selection and ICSI outcomes were compared between the two groups. A statistical significant difference was accepted when the p value was &lt;0.05.

Main results and the role of chance
Baseline clinical parameters were found to be comparable in the two groups. No differences regarding number of oocytes retrieved or MII oocytes were reported . he sperm selection was easier in the group A (time interval : 12±7,2 minutes) than group B (time interval : 22±10 minutes) (p &lt; 0,05). No significative difference was observed between goups in the Fertilization rate (group A : 66% vs group B : 68%) ; Cleavage rate (group A : 76.20% vs. Group B : 75.56%) and Blasulation rate (group A : 63.60% vs. Group B 60.61%) p &gt; 0 ,05. The Cumulative Pregnancy rate for group A (31. 5%) was higher than group B (30%, p &gt; 0 ,05). Indeed, The rate of frozen cycles is significantly higher for group A compared to group B (30% vs. 4.5% p &lt; 0,05).

Limitations, reasons for caution
Need large sample size.
Wider implications of the findings: Theophylline reduces significantly the time needed for sperm selection, Which positively affects the ICSI result.

Trial registration number
Not applicable