In-vitro culture of spermatozoa induces motility and increases implantation and pregnancy rates after testicular sperm extraction and intracytoplasmic sperm injection

The aim of this study was to determine the effect of 24-h in-vitro culture of testicular spermatozoa in recombinant follicle stimulating hormone (recF SH) supplemented medium versus simple medium on sperm motility, and to anal yse the outcome of intracytoplasmic sperm injection (ICSI) of such spermato zoa. A total of 143 positive testicular sperm extraction procedures in men with nonobstructive azoospermia was evaluated prospectively, Extracted test icular tissue samples were randomized to be cultured lit vitro for 24 h in simple medium or recFSH supplemented media, ICSI was performed with spermat ozoa cultured in recFSH (n = 73) or in simple medium (n = 70), Sperm motili ty following in-vitro culture, embryo quality after ICSI, and implantation and pregnancy rates were assessed, Of the 898 MH oocytes available in the r ecFSH group, 646 (71.9%) were injected with spermatozoa showing either twit ching or progressive motility. However, only 29.1% of the oocytes in the si mple medium group (245/841) were injected with motile spermatozoa (P < 0.05 ). Fertilization rate (68.8 versus 42.1%), implantation rate per embryo (20 .1 versus 13.2%), and clinical pregnancy rate (47.9 versus 30%) were signif icantly increased in the recFSH group compared with the simple medium group respectively (P < 0.05). In conclusion, in-vitro culture with recFSH appea rs to increase the motility of testicular spermatozoa, thus increasing the success of ICSI.