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15, 535–562 (2018)
Few studies comparing surgically-extracted vs. ejaculated sperm
Data overall reassuring concerning critical outcomes, including chromosomal abnormalities & overall neuro-psychological development
Palermo et al 1999; Vernaeve et al 2005 Fedder et al 2007; Belva et al 2011
Sandin et al. 2013; Esteves & Agarwal 2013
Lack of studies on Testi-ICSI vs. Ejac-ICSI (when both are available)
Esteves, 39
Most recent data
Testicular vs Ejaculated Sperm in Men with Sperm DNA Fragmentation
Arafa 2018
Zhang 2018
Herrero 2019
Prospective
Prospective
Retrospective
36 oligozoospermic and normozoospermic men with history of ICSI failure
102 oligozoospermic and normozoospermic men; No history of ICSI failure
145 couples with ICSI failure
SCD (30%)
SCSA (30%)
SCSA (25%) TUNEL (36%)
LBR 39% (T) vs. 8% (E) (P<0.0001)
LBR 36% (T) vs. 10% (E) (P=0.001)
• CLBR 22% (T) vs. 9% (E) (P<0.01; SCSA):
• CLBR 20% (T) vs. 0% (E) (P<0.02; TUNEL)
Esteves, 40
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