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Chapter 11 - Critical Factors for Optimizing Sperm Handling and ICSI Outcomes

from Part III - Laboratory Handling of Retrieved Sperm

Published online by Cambridge University Press:  09 April 2021

By
Edson Borges ,
Amanda Souza Setti  and
Daniela Paes de Almeida Ferreira Braga
Edited by
Ashok Agarwal ,
Ahmad Majzoub  and
Sandro C. Esteves
Ashok Agarwal
Affiliation:
The Cleveland Clinic Foundation, Cleveland, OH, USA
Ahmad Majzoub
Affiliation:
Hamad Medical Corporation, Doha, Qatar
Sandro C. Esteves
Affiliation:
Andrology & Human Reproduction Clinic, Sao Paulo, Brazil
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Summary

This chapter covers topics including: (1) timing of sperm retrieval, particularly whether or not it should be performed in conjunction with oocyte retrieval from the female partner; (2) processing of surgically retrieved sperm for intracytoplasmic sperm injection (ICSI) –which are the most appropriate types of sperm preparation techniques in cases of epidydimal- or testicular-retrieved spermatozoa, and low or high numbers of retrieved spermatozoa; (3) selection of surgically retrieved sperm for ICSI, including methods for the selection of immotile spermatozoa, if needed, such as mechanical touch technique, hypoosmotic swelling test, chemical motility enhancers (e.g., pentoxifylline and theophylline), laser-assisted immotile sperm selection, and birefringence–polarization microscopy; (4) artificial oocyte activation, which may be useful in those selected patients who might have low fertilization potential, as well as the potential benefits of mechanical activation, electrical stimulation, and chemical activation on ICSI outcomes.

Keywords

timingICSImechanical touch techniquehypoosmotic swelling testchemical motility enhancerslaser-assisted immotile sperm selectionbirefringence–polarization microscopyartificial oocyte activation
Type
Chapter
Information
Manual of Sperm Retrieval and Preparation in Human Assisted Reproduction , pp. 90 - 98
Publisher: Cambridge University Press
Print publication year: 2021

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