The Use of Testicular Sperm for Intracytoplasmic Sperm Injection in Patients with High Sperm DNA Damage: A Systematic Review

The advent of intracytoplasmic sperm injection (ICSI) has changed the human reproduction landscape by overcoming several limitations related to both male and female infertility factors. However, despite the development of new technologies, the live-birth rate with ICSI has not exceeded 30%. In order to improve assisted reproductive technology outcomes, advanced sperm function analysis have gained increased attention and the effects of sperm DNA fragmentation (SDF) on assisted reproduction success are being extensively studied. Utilizing ejaculated sperm with an elevated SDF has been found to result in poor ICSI outcomes. Furthermore, studies have reported that testicular sperm has lower SDF level, when compared to ejaculated sperm. Ibis has led a number of clinicians world-wide to offer testicular sperm retrieval for ICSI in non-azoospermic males with high SDF. This practice has remained controversial due to lack of high quality evidence.

Automated summary

The introduction of ICSI has addressed limitations in human reproduction related to male and female infertility, but the live-birth rate has not surpassed 30%. Advanced sperm function analysis, particularly regarding sperm DNA fragmentation (SDF), has become a focus for improving assisted reproduction outcomes. Studies have shown that using testicular sperm with lower SDF levels may lead to better ICSI results, especially in non-azoospermic males with high SDF levels.