Chromosome Abnormalities in Embryos Derived from Microsurgical Epididymal Sperm Aspiration (MESA) and Testicular Sperm Extraction (TESE)

Authors: S.P. Weng, , T.C. Jackson Wu, S. Park Kang, M.W. Surrey, H.C. Danzer and D.L. Hill, PhD, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, ART Reproductive Center, Beverly Hills, CA

Background and Significance: Sperm from patients with extremely severe male factor infertility have higher frequencies of aneuploidy than that observed in the normal population. Therefore, preimplantation genetic diagnosis (PGD) may be helpful in screening for chromosomal abnormalities prior to embryo transfer.

Objective: To evaluate the patterns of chromosome abnormalities in embryos derived from ICSI in MESA and TESE patients.

Materials and Methods: Patients with severe male factors requiring ICSI who also had PGD performed were enrolled. The sources of sperm included MESA, TESE, and ejaculation (EJAC). PGD was performed by FISH with probes for chromosomes 13, 18, 21, X, and Y. Additional chromosome 8, 9, 14, 15, 16, 17, 20, and 22 were examined if indicated. Chromosome abnormalities were categorized into polyploidy, haploidy, aneuploidy, and complex abnormal, which involved multiple chromosomes. Statistical analyses were performed using χ2 and Kruskalls–Wallis tests.

Results:

1. There was no difference in the rates of fertilization, percentages of euploid embryos, or pregnancy among three groups, although maternal age was more advanced in EJAC group (38.5 ± 4.3) as compared to MESA and TESE groups (33.8 ± 4.4 and 36.5 ± 4.0, respectively; p=.004; Table 1).