Title:Analysis of the Growth and Development of Children Born with ICSI of
Epididymal and Testicular Spermatozoa: A Propensity Matching Study
Volume: 29
Issue: 33
Author(s): Chunmei Yu, Chao Zhou, Feng Lin, Wanchao Zhang, Xiaoyu Wang, Lingmin Hu*Renjie Lu*
Affiliation:
- Changzhou Medical Center, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Jiangsu,
Changzhou, China
- Changzhou Medical Center,
Changzhou Third People's Hospital, Nanjing Medical University, Jiangsu, China
Keywords:
Intracytoplasmic sperm injection, ejaculated, non-ejaculated, growth, development, non-obstructive azoospermia.
Abstract:
Objective: The study aimed to evaluate whether singleton live births (at 0, 1, 6, 12, and 24 months)
following intracytoplasmic sperm injection (ICSI) using sperm of different origins (ejaculated or non-ejaculated
sperm) are associated with the growth and development of children born.
Methods: This was a retrospective cohort study conducted at a single center from January 2016 to December
2019. Follow-up data of the children were obtained from the Jiangsu Province Maternal and Child database. A
total of 350 singleton live births after fresh embryo transfer (ET) with ICSI were included. Based on the origin
of the sperm, the patients were divided into two groups: the ejaculated group (n = 310) and the non-ejaculated
group (n = 40). Propensity score matching was used to control for multiple baseline covariates, resulting in 80
singleton live births (ejaculated sperm) matched to 40 singleton live births (non-ejaculated). The non-ejaculated
group was further divided into two subgroups: the PESA group (n = 23) and the TESA group (n = 17). The
primary outcome of the study was the growth and development of children. Secondary outcomes included the
2PN rate, high-cleavage embryo rate, blastocyst formation rate, and others.
Results: After matching parental age, BMI, occupation, and maternal serum AMH level, there was no significant
difference found in the growth and development of children between the non-ejaculated and ejaculated
group or the PESA group and TESA group, respectively. However, the 2PN rate and the blastocyst formation
rate were higher in the ejaculated group compared to the non-ejaculated group (91.02 and 85.45, P = 0.002)
and (67.37 and 56.06, P = 0.019), respectively. The high-quality cleavage embryo rate was also higher in the
TESA group compared to the PESA group (85.06 and 65.63, P = 0.001).
Conclusion: This study suggests that there are no significant differences in the growth and development of
children born following ICSI using sperm of different origins (ejaculated or non-ejaculated). For nonobstructive
azoospermia (OA) patients, sperm derived from the testis may be more effective than derived from the epididymis.
However, due to the limited sample size of the non-ejaculated group in this study, further investigations
with larger sample sizes are needed to validate these findings.
