Author/Editor     Kovačič, Borut; Vlaisavljević, Veljko; Reljić, Milan
Title     Clinical use of pentoxifylline for activation of immotile testicular sperm before ICSI in patients with azoospermia
Type     članek
Source     J Androl
Vol. and No.     Letnik 27, št. 1
Publication year     2006
Volume     str. 45-52
Language     slo
Abstract     The testicular sperm from biopsy and frozen/thawed tissue are frequently immotile. The purpose of our retrospective study was to assess the effect of short exposure of testicular samples with only immotile sperm to pentoxifylline (PF)-sperm motility stimulator. In 77 of 294 (16.2%) testicular sperm ablation/testicular sperm extraction-intracytoplasmic sperm injection (TESA/TESE-ICSI) cycles in patients with azoospermia, only immotile sperm were found in biopsies even after 2 hours of incubation of tissue in the medium. These 77 cycles were divided into 2 groups. In group 1 (cycles between 1999 and 2001; n=30), ICSI was performed with untreated immotile sperm. In group 2 (cycles between 2002 and 2004; n=47), immotile testicular sperm were treated for 20 minutes with pentoxifylline (PF) (1,76mM) before ICSI. Both groups had the same proportion of ICSI cycles with fresh, frozen/thawed, and aspiratedtesticular sperm. The overall pregnancy rate of TESA/TESE-ICSI did not vary during the study period. In 45 of 47 (95.7%) testicular samples with total immotility, the sperm started to move 20 minutes after PF treatment. The mean time required for ICSI was shortened in the PF group (30 minutes (minimum 10, maximum 90) vs 120 minutes(minimum 60, maximum 240)) due to easier identification of motile sperm. In comparison with the nontreated group, the PF group had a higher fertilization rate (66% vs 50.9%, P<.005) and mean number of embryos per cycle (4.7+-3.3 vs 2.7+-2.1; P<.01). The clinical pregnancy rate per cycle in PF and non PF groups was 38.3% and 26.7%, respectively. By using PF in cases of only immotile testicular sperm we can cause movement of testicular sperm, allow easier identification of vital sperm, shorten the procedure, improve fertilization rates, and increase the number of embryos.
Descriptors     INFERTILITY, MALE
OLIGOSPERMIA
SPERM MOTILITY
PENTOXIFYLLINE
TESTIS
BIOPSY
SPERMATOZOA
FERTILIZATION IN VITRO
EMBRYO TRANSFER
OOCYTES