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Surgically acquired sperm use for assisted reproductive technology: trends and perinatal outcomes, USA, 2004–2015

  • Assisted Reproduction Technologies
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Abstract

Purpose

To compare national trends and perinatal outcomes following the use of ejaculated versus surgically acquired sperm among IVF cycles with male factor infertility.

Methods

This retrospective cohort includes US fertility clinics reporting to the National ART Surveillance System between 2004 and 2015. Fresh, non-donor IVF male factor cycles (n = 369,426 cycles) were included. We report the following outcomes: (1) Trends in surgically acquired and ejaculated sperm. (2) Adjusted risk ratios comparing outcomes for intracytoplasmic sperm injection (ICSI) cycles using surgically acquired (epididymal or testicular) versus ejaculated sperm. (3) Outcomes per non-canceled cycle: biochemical pregnancy, intrauterine pregnancy, and live birth (≥ 20 weeks). (4) Outcomes per pregnancy: miscarriage (< 20 weeks) and singleton pregnancy. (5) Outcomes per singleton pregnancy: normal birthweight (≥ 2500 g) and full-term delivery (≥ 37 weeks).

Results

Percentage of male factor infertility cycles that used surgically acquired sperm increased over the study period, 9.8 (2004) to 11.6% (2015), p < 0.05. The proportion of cycles using testicular sperm increased significantly over the study period, 4.9 (2004) to 6.5% (2015), p < 0.05. Among fresh, non-donor male factor ART cycles which used ICSI (n = 347,078 cycles), cycle, pregnancy, and perinatal outcomes were statistically significant but clinically similar with confidence intervals approaching one between cycles involving epididymal versus ejaculated sperm and between testicular versus ejaculated sperm. Results were similar among cycles with a sole diagnosis of male factor (no female factors), and for the subset in which the female partner was < 35 years old.

Conclusion

Among couples undergoing ART for treatment of male factor infertility, pregnancy and perinatal outcomes were similar between cycles utilizing ejaculated sperm or surgically acquired testicular and epididymal sperm.

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Author information

Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA

    Jennifer F. Kawwass, Akanksha Mehta & Dmitry M. Kissin

  2. Division of Reproductive Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 550 Peachtree Street, Suite 1800, Atlanta, GA, 30308, USA

    Jennifer F. Kawwass, Jeani Chang, Sheree L. Boulet & Dmitry M. Kissin

  3. Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA

    Ajay Nangia

  4. Department of Urology, Emory University School of Medicine, Atlanta, GA, USA

    Akanksha Mehta

Authors
  1. Jennifer F. Kawwass
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  2. Jeani Chang
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  3. Sheree L. Boulet
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  4. Ajay Nangia
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  5. Akanksha Mehta
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  6. Dmitry M. Kissin
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Corresponding author

Correspondence to Jennifer F. Kawwass.

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The Centers for Disease Control and Prevention institutional review board approved this study.

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Conflict of interest

The authors did not report any potential conflicts of interest. AM was supported by a research grant from the American Society for Reproductive Medicine.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Kawwass, J.F., Chang, J., Boulet, S.L. et al. Surgically acquired sperm use for assisted reproductive technology: trends and perinatal outcomes, USA, 2004–2015. J Assist Reprod Genet 35, 1229–1237 (2018). https://doi.org/10.1007/s10815-018-1178-5

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  • DOI: https://doi.org/10.1007/s10815-018-1178-5

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