Using testicular sperm for men with low sperm count

This paper studied whether using testicular sperm is effective for men with severe oligospermia. Researchers reported a 50% pregnancy rate, all resulting in live births.

Oligospermia refers to a low sperm count in the ejaculate. It is a common cause of male infertility. Sperm in the ejaculate is often associated with better fertilization potential than harvesting sperm from the testicles. This is because ejaculatory sperm have completed the maturation process through the male reproductive tract. However, following recent advances in assisted reproductive technologies, testicular sperm may be able to achieve similar pregnancy rates as ejaculated sperm. This may be of particular benefit for men with oligospermia. More studies are needed to examine pregnancy outcomes with the use of testicular sperm.

24 men with severe oligospermia were studied. On average, the men included had undergone an average of 2.3 failed cycles of either in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). All men underwent a procedure to extract sperm from the testicles with a fine needle. ICSI was then performed, where a single testicular sperm is used to fertilize an egg and then implanted. A genetic test then evaluated how healthy the sperm's genetic code is.

The genetic test revealed that 24% of ejaculated sperm had damaged DNA. This was significantly greater compared to testicular sperm (5%).

The use of testicular sperm was associated with a 50% pregnancy rate. All pregnancies resulted in the delivery of healthy children. There was no significant difference in parental age, number of previous pregnancies, number of previous assisted reproductive technology attempts, amount of retrieved sperm, number of eggs retrieved, fertilization rate, or number of embryos transferred between couples who did and those who did not achieve pregnancy. 

The authors concluded that the use of testicular sperm was associated with a 50% pregnancy and live birth rate for couples who had previously failed IVF/ICSI cycle with ejaculated sperm. 

Larger studies are needed to confirm these results.