Enhancement of Sperm Motility in Assisted Reproduction

[摘要] One of the benefits of being a urologist who deals with male infertility issues and who has the pleasure of working at an academic institution that does not have an in-house in vitro fertilization (IVF) center is that I travel to a number of outlying IVF centers to perform sperm aspiration procedures. When one has to go into the testis itself to get the sperm, there are 2 ways of accomplishing this: 1) TESA (testicular sperm aspiration), which essentially is placing a needle into the testis and aspirating the “intra-testicular fluid”; and 2) TESE (testicular sperm extraction), which is excising testicular tissue from the testis. TESA is favored by non-urological andrologists (for obvious reasons, given that it does not involve “cutting”), and at some IVF centers TESA might be performed by an endocrinologist, a reproductive gynecologist, or even an internist interested in andrology. TESE is usually performed by the urologist. Regardless of whether TESA or TESE is used to obtain the sperm, one constant finding is that the intratesticular sperm might not be motile. The conundrum is whether the sperm are asleep or dead. The importance of this is that the use of motile sperm in intracytoplasmic sperm injection (ICSI)-IVF significantly increases the efficacy of the procedure.

[学科分类] 基础医学