THE ACHIEVEMENT OF PREGNANCIES USING ASSISTED REPRODUCTIVE TECHNOLOGIES FOR MALE FACTOR INFERTILITY AFTER RETROPERITONEAL LYMPH-NODE DISSECTION FOR TESTICULAR-CARCINOMA
Ls. Hakim et al., THE ACHIEVEMENT OF PREGNANCIES USING ASSISTED REPRODUCTIVE TECHNOLOGIES FOR MALE FACTOR INFERTILITY AFTER RETROPERITONEAL LYMPH-NODE DISSECTION FOR TESTICULAR-CARCINOMA, Fertility and sterility, 64(6), 1995, pp. 1141-1146
Objective: To evaluate the success of electroejaculation with assisted
reproductive technologies (ART) in anejaculate men after retroperiton
eal lymph node dissection (RPLND) for testicular cancer. Design: Retro
spective clinical study. Setting: Tertiary care, university-affiliated
IVF program. Patients: Anejaculate men after RPLND, spouses. Interven
tions: Electroejaculation, microsurgical sperm aspiration, various ass
isted reproductive technologies. Main Outcome Measures: Sperm density
and motility, fertilization rate, pregnancy rate (PR). Results: Compar
ed with patients not receiving chemotherapy, patients who received che
motherapy had diminished average sperm densities and motilities (63 x
10(6) and 20% versus 101 x 10(6) and 32%, respectively); decreased fer
tilization rates per cycle for IVF and intracytoplasmic sperm injectio
n (ICSI) (11% versus 26%, respectively); lower PRs per cycle of hMG-IU
I and IVF (14% versus 60% and 8% versus 50%, respectively). No pregnan
cies were achieved with natural cycle-TUI, clomiphene citrate-IUI, or
GIFT. Two couples progressed to intracytoplasmic sperm injection with
one achieving the successful delivery of healthy twins. The overall PR
per cycle was 22%. Conclusions: Patients receiving chemotherapy had d
ecreased sperm densities, motilities, fertilization, and PRs for each
modality used. Rectal probe electroejaculation with ART can help aneja
culate men after RPLND achieve biologic paternity. An early move to th
e more aggressive therapies (hMG-IUI, IVF, ICSI) is supported.