Timing of Sperm Harvesting: Is There Room for Improvement?

[摘要] For urologists who treat infertility as part of their practice, it is not unusual to be “on call” to harvest sperm from the male partner of a couple undergoing in vitro fertilization (IVF). The timing of sperm harvesting is directly related to the day that egg retrieval of the female partner is going to occur. Some embryologists (who manipulate the sperm in the IVF laboratory and perform intracytoplasmic sperm injection [ICSI]) strongly believe that the sperm should be retrieved from the male partner on the same day that egg retrieval occurs. Conversely, other embryologists have no objection to performing sperm harvesting the day before egg retrieval, particularly if the sperm harvesting procedure is to be testicular sperm extraction (TESE). With TESE the sperm that are extracted from the tubules of the testicular tissue may take a while to obtain motility, which is the main in vitro criterion for choosing which sperm are to be used for the IVF plus ICSI process. By performing TESE the day before egg retrieval, the laboratory personnel allow themselves enough time to dissect the testicular tissue and retrieve the sperm, particularly in the case of nonobstructive azoospermic patients, for whom spermatogenesis may be severely impacted and in whom it may take a long time, relatively speaking, to find sperm in the tissue. However, some embryologists insist that sperm retrieved the day before egg retrieval do not “survive” as well as sperm retrieved the day of egg retrieval.

[学科分类] 基础医学