Androlog Mail:
> For a man with 100% immotile sperm in the ejaculate, of which 10% are live,
> pregnancy rates better with ICSI / TESE-ICSI
...
> 10% viable sperms should be good enough for ICSI.
> Why TESE-ICSI, if one can get 10% viable sperms in the ejaculate?
> Moreover, TESE is associated with complications - like fibrosis.
> Shankar Periasamy
> shankar@pc.jaring.my
...
>> TESE because you cannot pick out which of the 10% are viable sperm to
>> inject with good reliability. HOS test may help but data on it's use for
>> ICSI involves small numbers. You are much more likely to have higher
>> viability from the testis (assuming no motile sperm are found in the vas or
>> epididymis) than from the ejaculate.
>> Marc Goldstein
>> mgoldst@mail.med.cornell.edu
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It is true that 10% viable sperms should be good enough for ICSI.
Our experience with such situation is that (1) the outcome (in terms of
fertilization and pregnancy rates) is the same between viable
(non-motile) testicular sperm and viable (non-motile) ejaculated sperm;
(2) motile spermatozoa can be found in some (about 40%) of the
patients with 100% immotile sperm in ejaculated semen. This is the only
reason that testicular biopsy is carried out in patients with 100%
non-motile ejaculated sperm in our Center, (3) for selection of viable
sperm using HOST, please see our publications (Liu et al., Fertil & Steril.
1997;68:373-5; Tsai et al., Hum Reprod. 1997;12:1111-3).
Jiaen Liu, The GBMC Fertility Center, Baltimore, MD
e-mail: jliu@gbmc.org
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