{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T10:35:30Z","timestamp":1777286130769,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T00:00:00Z","timestamp":1549497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP86636"],"award-info":[{"award-number":["MOP86636"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2019,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n The use of testicular over ejaculated spermatozoa for\n ICSI<\/jats:styled-content>\n has been presented as an alternative to overcome infertility in men with poor semen parameters or high levels of sperm\n DNA<\/jats:styled-content>\n fragmentation.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To evaluate the efficacy of testicular\n ICSI<\/jats:styled-content>\n outcomes in couples with no previous live birth and recurrent\n ICSI<\/jats:styled-content>\n failure using ejaculated spermatozoa by comparison to the outcomes of couples with similar history of recurrent\n ICSI<\/jats:styled-content>\n using ejaculated spermatozoa only.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n A total of 145 couples undergoing ejaculated or testicular\n ICSI<\/jats:styled-content>\n cycles with no previous live births and with at least two previous failed\n ICSI<\/jats:styled-content>\n cycles with ejaculated spermatozoa were evaluated retrospectively.\n ICSI<\/jats:styled-content>\n was performed either with ejaculated (E\u2010\n ICSI<\/jats:styled-content>\n ) or with testicular (T\u2010\n ICSI<\/jats:styled-content>\n ) spermatozoa. Semen parameters and sperm\n DNA<\/jats:styled-content>\n quality were assessed prior to the oocyte collection day. Primary outcomes included cumulative live birth and pregnancy rates. Secondary analysis included percentage of\n DNA<\/jats:styled-content>\n fragmentation in ejaculated spermatozoa (\n SCSA<\/jats:styled-content>\n \u00ae<\/jats:sup>\n and\n TUNEL<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Patients undergoing T\u2010\n ICSI<\/jats:styled-content>\n (\n n<\/jats:italic>\n \u00a0=\u00a077) had a significantly higher clinical pregnancy rate\/fresh embryo transfer (\n ET<\/jats:styled-content>\n ) (27.9%; 17\/61) and cumulative live birth rate (23.4%; 15\/64) compared to patients using E\u2010\n ICSI<\/jats:styled-content>\n (\n n<\/jats:italic>\n \u00a0=\u00a068) (clinical pregnancy rate\/fresh\n ET<\/jats:styled-content>\n : 10%; 6\/60 and cumulative live birth rate: 11.4%; 7\/61). Further, T\u2010\n ICSI<\/jats:styled-content>\n yield significantly better cumulative live birth rates than E\u2010\n ICSI<\/jats:styled-content>\n for men with high\n TUNEL<\/jats:styled-content>\n (\u226536%) (T\u2010\n ICSI<\/jats:styled-content>\n : 20%; 3\/15 vs. E\u2010\n ICSI<\/jats:styled-content>\n : 0%; 0\/7,\n p<\/jats:italic>\n \u00a0<\u00a00.025), high\n SCSA<\/jats:styled-content>\n \u00ae<\/jats:sup>\n (\u226525%) scores (T\u2010\n ICSI<\/jats:styled-content>\n : 21.7%; 5\/23 vs. E\u2010\n ICSI<\/jats:styled-content>\n : 9.1%; 1\/11,\n p<\/jats:italic>\n \u00a0<\u00a00.01), or abnormal semen parameters (T\u2010\n ICSI<\/jats:styled-content>\n : 28%; 7\/25 vs. E\u2010\n ICSI<\/jats:styled-content>\n : 6.7%; 1\/15,\n p<\/jats:italic>\n \u00a0<\u00a00.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The use of testicular spermatozoa for\n ICSI<\/jats:styled-content>\n in non\u2010azoospermic couples with no previous live births, recurrent\n ICSI<\/jats:styled-content>\n failure, and high sperm\n DNA<\/jats:styled-content>\n fragmentation yields significantly better live birth outcomes than a separate cohort of couples with similar history of\n ICSI<\/jats:styled-content>\n failure entering a new\n ICSI<\/jats:styled-content>\n cycle with ejaculated spermatozoa.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/andr.12591","type":"journal-article","created":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T02:49:09Z","timestamp":1549594149000},"page":"281-287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["ICSI<\/scp>\n outcomes using testicular spermatozoa in non\u2010azoospermic couples with recurrent\n ICSI<\/scp>\n failure and no previous live births"],"prefix":"10.1111","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6276-5581","authenticated-orcid":false,"given":"M. B.","family":"Herrero","sequence":"first","affiliation":[{"name":"MUHC Reproductive Centre McGill University Health Centre Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5974-6577","authenticated-orcid":false,"given":"M. F.","family":"Lusignan","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.\u2010Y.","family":"Son","sequence":"additional","affiliation":[{"name":"MUHC Reproductive Centre McGill University Health Centre Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Sabbah","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.\u00a0","family":"Buckett","sequence":"additional","affiliation":[{"name":"MUHC Reproductive Centre McGill University Health Centre Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Chan","sequence":"additional","affiliation":[{"name":"MUHC Reproductive Centre McGill University Health Centre 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