Abstract: PD68-02
Sources of Funding: none

Introduction

The sperm centrosome plays an important role in early embryo development. Paternal effect on embryonic cleavage and blastocyst formation can be affected in cases of severe male infertility where spermatogenesis is abnormal. We compared morphokinetics of embryonic development in patient embryos created from sperm extracted from the testis and epididymis.

Methods

The charts of 72 men with severe oligospermia or azoospermia who underwent successful IVF/ICSI were retrospectively reviewed. _x000D_ Demographics, endocrine labs, semen analysis, genetic testing data, pathologic diagnosis and location of sperm extraction were analyzed. Zygotes were cultured in the Embryscope time lapse imaging chamber. Kinetic data and cycle outcome data were analyzed. Clinical pregnancy rate (CPR), implantation rate (IR) and blastulation rate were calculated.

Results

41 men (56.9%) underwent sperm extraction from the testis with 28 (68.3%) having a microTESE. 31 men (43.1%) had epididymal sperm extraction, with the 74.2% having a percutaneous extraction. The most common diagnosis in the epididymal group was presence of vasectomy (61.3%) and idiopathic nonobstructive azoospermia (63.4%) in the testicular group. The average FSH (mU/mL) in the epididymal group was 3.8 and was 17.6 in the testicular group (p = 0.051). There was no difference in LH (p = 0.88), testosterone (p = 0.46) or estradiol (0.725) between the two groups. CPR and IR in the testicular sperm group (51% and 31%, respectively) was similar to that of the epididymal group (57% and 37%, respectively). Embryos in the testicular sperm group were significantly slower in reaching early kinetic endpoints (t2,t4,t8), though tM, tSB and tEBL from both groups were similar. The mean day 3 embryo cell count was lower with testicular (7.69 +/- 2.09) vs epididymal derived (8.65 +/- 2.73; p=0.03) embryos. There was an increased percentage of embryos in the testicular group that failed to compact (TESE 31%,vs PESA 16%; P<0.0001).

Conclusions

Delayed developmental times were observed in embryos derived from testicular sperm up until the stage of compaction (an early indicator of embryonic genomic activation). Embryos from the testicular group arrested at a higher rate prior to this stage but after this stage, they had similar kinetics as epididymal derived embryos. _x000D_ Larger, prospective studies examining sperm quality in testicular extraction patients and its relationship to embryo kinetics may help to further elucidate these results.

Funding

none