Optimizing the outcome of ART in male infertility Micro-TESE more effective than conventional TESE Verza & Esteves, Microsurgical versus conventional single-biopsy testicular spermĮxtraction in nonobstructive azoospermia: a prospective controlled study, FertilityĪnd Sterility, Volume 96, Issue 3, Supplement, September 2011, Page S53 Prospective controlled study on 60 patients) Overall Hypospermatogenesis Maturation Arrest Sertoli-cell only Hum.Īn isolated region of morphologically normal Testicular sperm extraction: microdissection improves sperm yield with minimal – Excise small quantity of testicular tissue Method to identify the site(s) of production - based on the.Sperm Retrieval Techniques for Assisted Reproduction. – Microsurgical Testicular Sperm ExtractionĮsteves SC et al. Scientific evidence for a beneficial effect on theĬlinical pregnancy rate is of very low quality. Miscarriage rate, and that the quality of the Since there is no effect on live birth or A meta-analysis of randomized controlled.Hazout et al (2006) FR NA PR 38% versus 2% (S)Īntinori et al (2008) FR NA PR 39% versus 27% (S) Normal nucleus by MSOME when pregnant versus not pregnant 34%īartoov et al (2003) FR 63% versus. Morphologically selected sperm injection (IMSI) Method into ICSI procedure led to intracytoplasmic – the selection of motile spermatozoa with a morphologically – low magnification used that permits to observeĮvaluation called “motile sperm organelle this selection has certain limitations –.On evaluation of their head, neck and tail. Microscope with magnification of 200×-400×, (vacuolar areas) -> most important part of Nucleus for shape and chromatin content.– Mitochondria -> categorized as normal or abnormal – Tail -> categorized as normal or abnormal – Neck -> categorized as normal or abnormal – Post-acrosomal lamina -> categorized as normal or HBA score when FR >50 versus HBA score when FR ≤50%:įR when HBA score ≥80% versus FR when HBA score categorized as normal or abnormal Not much improvement in fertilization rates/ pregnancy.Better embryo quality and cleavage rates.Įffects on ART outcome – what does the evidence tell.– Spermatozoa with fragmented DNA > 25% -> poor fertilityĭNA fragmentations >30 has no evidence ofĭefined by Creatinine Kinase, HspA2 & Aniline Blue staining – Spermatozoa with fragmented DNA 15-25% -> average fertility – Spermatozoa with fragmented DNA ≤ 15% –> good fertility Results from both assays are expressed as percentage of sperm demonstrating – SCSA is the only test with clear and clinically useful cut off levels for – Measures the susceptibility of DNA to acid induced denaturation Single stranded DNA from native double stranded DNA – Measures the susceptibility of DNA to denaturation –> formation of Morphology 30% or more with normal forms 4.0% (3.0–4.0). Total sperm count : 40 million or more 39 million per ejaculate (33–46) Sperm concentration 20 million or more 15 million per ml (12–16) Male infertility what makes a good predictive test,ANTIOXIDANTS, lifecare centre, lifecare IVF centre

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