吳建志1,2,5,7、康以諾2、蕭雅文4、陳建宇2,3,6,7 
臺北醫學大學附設醫院 1泌尿科，2教學部，3麻醉科；
臺北醫學大學 4醫學系 5泌尿學科，6麻醉學科，7醫學教育暨人文學科
ICSI outcomes using testicular versus ejaculated sperm among infertile patients with cryptozoospermia: A systemic review and meta-analysis  

Chien-Chih Wu1,2,4,7、Yi-No Kang2、Ya-Wen Hsiao4、Chien-Yu Chen2,3,6,7
Depart. of 1Urology, 2Medical Education, 3Anesthesiology, Taipei Medical University Hospital; College of Medicine, 4School of Medicine, Taipei Medical University;
School of Medicine, Depart. of 5Urology, 6Anesthesiology, 7Education and Humanities in Medicine, Taipei Medical University
 

Purpose: To compare the outcomes of intracytoplasmic sperm injection (ICSI) using extracted testicular sperm versus ejaculated sperm among infertile patients with cryptozoospermia.

Materials and Methods: We performed systemic search using PubMed, Embase, and Cochrane databases. The inclusion criteria were studies comparing the outcomes of ICSI, inclusion fertilization, implantation and pregnancy rate, among infertile patients with cryptozoospermia using extracted testicular sperm versus ejaculated sperm.

Results: Totally 255 references were collected. Eight articles compatible with the inclusion criteria were obtained after excluding the duplicated, not relevant, not human, different situation, different comparisons, different study type, and conference articles. They were all retrospective cohort studies. After appraising with Newcastle-Ottawa Quality Assessment Form for Cohort Studies, finally six articles as good quality were selected. We conducted meta-analysis. Three domains of ICSI outcomes were evaluated. There were no differences in fertilization rates (odds ratio 1.26 from original data and 1.03 from estimated data) between testicular and ejaculated sperm. The implantation (odds ratio 2.66, 95% CI 1.81~3.91), and the pregnancy (odds ratio 2.62, 95% CI 1.53~4.48 according to embryos numbers, and odds ratio 1.96, 95% CI 1.15~3.34 according to treating cycles) showed significant higher rates between testicular and ejaculated sperm.

Conclusions: Using testicular retrieved sperm is able to achieve higher rates of embryo implantation, and pregnancy compared with those using ejaculated sperm for ICSI treatment in infertile patients with cryptozoospermia.

 

 

 

 

 

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