Original scientific paper
https://doi.org/10.3325/cmj.2025.66.367
The ejaculate obtained on the morning of microdissection testicular sperm extraction (m-TESE) or m-TESE itself in repeated intracytoplasmic sperm injection failure due to severe male infertility? A retrospective study
Sule Atalay Mert
; Department of Reproductive Endocrinology and In Vitro Fertilization, Gulhane Training and Research Hospital, Ankara, Turkey
*
Mustafa Ozturk
; Department of Reproductive Endocrinology and In Vitro Fertilization, Gulhane Training and Research Hospital, Ankara, Turkey
Tugba Kinay
; Department of Obstetrics and Gynecology, Etlik City Hospital, Ankara, Turkey
Ulaş Fidan
; Department of Reproductive Endocrinology and In Vitro Fertilization, Gulhane Training and Research Hospital, Ankara, Turkey
Ozhan Ozdemir
; Department of Reproductive Endocrinology and In Vitro Fertilization, Gulhane Training and Research Hospital, Ankara, Turkey
Turgay Ebiloglu
; Department of Urology, Gulhane Training and Research Hospital, Ankara, Turkey
Cem Korkmaz
; Department of Embryology, Gulhane Training and Research Hospital, Ankara, Turkey
Seyit Temel Ceyhan
; Department of Reproductive Endocrinology and In Vitro Fertilization, Gulhane Training and Research Hospital, Ankara, Turkey
* Corresponding author.
Abstract
Aim To compare intracytoplasmic sperm injection (ICSI)
outcomes between oligoasthenoteratozoospermic (OAT)
men with recurrent assisted reproductive technology (ART)
failures who underwent ICSI using sperm from the ejaculate
on the day of a planned microdissection testicular sperm
extraction (m-TESE) vs sperm obtained via m-TESE.
Methods We reviewed the outcomes of men who under
went ICSI using either ejaculate or m-TESE due to OAT and
recurrent ART failure at the Department of Reproductive
Endocrinology, Gülhane Training and Research Hospital,
between November 2016 and January 2024. The study en
rolled 172 men: 66 men in the ejaculate group and 106 in
the m-TESE group. All patients had fewer sperm parame
ters in two subsequent semen analyses.
Results The groups did not significantly differ in terms of
female (P = 0.631) or male (P = 0.655) age. Sperm was ob
tained from 76/106 men in the m-TESE group (69.81%). The
embryo transfer rate on day three was significantly high
er in the m-TESE group (32.2% vs 8.3%; P = 0.003), where
as, on day five, it was significantly higher in the ejaculate
group (61.7% vs 37.9%; P = 0.015). The ejaculate group
had significantly higher overall pregnancy rates (59.1% vs
33%; P = 0.001) and overall live birth rates (37.9% vs 22.6%;
P = 0.031).
Conclusion In recurrent ICSI failure, the reproductive suc
cess of ejaculate was higher than that of m-TESE. If it con
tains motile spermatozoa, the ejaculate before m-TESE
could be considered even in severe OAT patients with two
or more ART/ICSI failures
Keywords
Hrčak ID:
352552
URI
Publication date:
22.10.2025.
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