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Debate on the Use of Testicular Sperm for ICSI: Con

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A Clinician's Guide to Sperm DNA and Chromatin Damage

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Abstract

There has been a growing interest in the current literature on the use of surgically retrieved testicular sperm for ICSI despite the availability of ejaculated sperm, particularly when there is recurrent ICSI failure and abnormal semen quality. This idea was supported by a number of recent studies that are mostly small retrospective series and case reports. The design of studies often did not have proper comparison groups, did not demonstrate significant benefit on live-birth rates, and may be prone to various sources of bias. Thus, the evidence supporting the notion that testicular sperm is superior to ejaculated sperm for ICSI is at best circumstantial. Various questions remained to be answered. New studies with proper design must be conducted to identify what type of patients may benefit from repeating ICSI with testicular over ejaculated sperm and to what extent this benefit could be expected. Further studies should also identify the type of couples that should not consider such an option to avoid unnecessary cost and risk with repeating ICSI using surgically retrieved testicular sperm. Until data with acceptable quality are available, clinicians should be prudent in counseling these vulnerable infertile couples who experienced recurrent unexplained failure of ICSI on further fertility management options.

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The contents of this chapter are presented for informational and academic purposes only. It should not be used by patients in isolation without proper clinical counseling with experienced healthcare professionals to make any clinical decisions on their fertility management.

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  1. Department of Surgery (Urology), McGill University and the McGill Univeristy Health Centre, Montréal, QC, Canada

    Peter T. K. Chan

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Correspondence to Peter T. K. Chan .

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Editors and Affiliations

  1. Department of Surgery, Division of Urology, McGill University, Montreal, Québec, Canada

    Armand Zini

  2. American Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Ashok Agarwal

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Chan, P.T.K. (2018). Debate on the Use of Testicular Sperm for ICSI: Con. In: Zini, A., Agarwal, A. (eds) A Clinician's Guide to Sperm DNA and Chromatin Damage. Springer, Cham. https://doi.org/10.1007/978-3-319-71815-6_30

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  • DOI: https://doi.org/10.1007/978-3-319-71815-6_30

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