<scp>ICSI</scp> outcomes using testicular spermatozoa in non‐azoospermic couples with recurrent <scp>ICSI</scp> failure and no previous live births
Bibliographic record
Abstract
Abstract Background The use of testicular over ejaculated spermatozoa for ICSI has been presented as an alternative to overcome infertility in men with poor semen parameters or high levels of sperm DNA fragmentation. Objective To evaluate the efficacy of testicular ICSI outcomes in couples with no previous live birth and recurrent ICSI failure using ejaculated spermatozoa by comparison to the outcomes of couples with similar history of recurrent ICSI using ejaculated spermatozoa only. Materials and Methods A total of 145 couples undergoing ejaculated or testicular ICSI cycles with no previous live births and with at least two previous failed ICSI cycles with ejaculated spermatozoa were evaluated retrospectively. ICSI was performed either with ejaculated (E‐ ICSI ) or with testicular (T‐ ICSI ) spermatozoa. Semen parameters and sperm DNA quality were assessed prior to the oocyte collection day. Primary outcomes included cumulative live birth and pregnancy rates. Secondary analysis included percentage of DNA fragmentation in ejaculated spermatozoa ( SCSA ® and TUNEL ). Results Patients undergoing T‐ ICSI ( n = 77) had a significantly higher clinical pregnancy rate/fresh embryo transfer ( ET ) (27.9%; 17/61) and cumulative live birth rate (23.4%; 15/64) compared to patients using E‐ ICSI ( n = 68) (clinical pregnancy rate/fresh ET : 10%; 6/60 and cumulative live birth rate: 11.4%; 7/61). Further, T‐ ICSI yield significantly better cumulative live birth rates than E‐ ICSI for men with high TUNEL (≥36%) (T‐ ICSI : 20%; 3/15 vs. E‐ ICSI : 0%; 0/7, p < 0.025), high SCSA ® (≥25%) scores (T‐ ICSI : 21.7%; 5/23 vs. E‐ ICSI : 9.1%; 1/11, p < 0.01), or abnormal semen parameters (T‐ ICSI : 28%; 7/25 vs. E‐ ICSI : 6.7%; 1/15, p < 0.01). Conclusions The use of testicular spermatozoa for ICSI in non‐azoospermic couples with no previous live births, recurrent ICSI failure, and high sperm DNA fragmentation yields significantly better live birth outcomes than a separate cohort of couples with similar history of ICSI failure entering a new ICSI cycle with ejaculated spermatozoa.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".