Testicular sperm is superior to ejaculated sperm for ICSI in cryptozoospermia: An update systematic review and meta-analysis

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作者
Yi-No Kang
Ya-Wen Hsiao
Chien-Yu Chen
Chien-Chih Wu
机构
[1] Taipei Medical University Hospital,Centre for Evidence
[2] Taipei Medical University,Based Medicine, Department of Education
[3] Taipei Medical University Hospital,School of Medicine, College of Medicine
[4] School of Medicine,Department of Anesthesiology
[5] College of Medicine,Department of Anesthesiology
[6] Taipei Medical University,Department of Education in Medicine and Humanity
[7] School of Medicine,Department of Urology
[8] College of Medicine,Department of Urology
[9] Taipei Medical University,undefined
[10] Taipei Medical University Hospital,undefined
[11] School of Medicine,undefined
[12] College of Medicine,undefined
[13] Taipei Medical University,undefined
来源
Scientific Reports | / 8卷
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摘要
Intracytoplasmic sperm injection (ICSI) is well established and provides patients with severely impaired sperm quality with an opportunity to father a child. However, previous studies do not clearly indicate whether male with cryptozoospermia should use testicular sperm or ejaculated sperm for ICSI. The newest systematic review of this topic also gave a controversial conclusion that was based on incorrect pooling result. Moreover, two clinical studies published after the systematic review. In the present update systematic review and meta-analysis, a comprehensive citation search for relevant studies was performed using the Cochrane library databases, Embase, Ovid MEDLINE, PubMed, ScienceDirect, Scopus, and Web of Science up to September 2017. The search returned 313 records, in which six studies were included in quantitative synthesis. These studies involved 578 male infertility patients who had undergone 761 ICSI cycles. The risk ratios favour fresh testicular sperm for good quality embryo rate (1.17, 95% CI 1.05–1.30, P = 0.005), implantation rate (95% CI 1.02–2.26, P = 0.04), and pregnancy rate (RR = 1.74, 95% CI 1.20–2.52, P = 0.004). In conclusion, the existing evidence suggests that testicular sperm is better than ejaculated sperm for ICSI in male with cryptozoospermia.
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