Do donor spermatozoa improve reproductive outcomes after oocyte donation failure? A retrospective analysis of cumulative live birth rates per donor oocyte consumed.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101122473 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1472-6491 (Electronic) Linking ISSN: 14726483 NLM ISO Abbreviation: Reprod Biomed Online Subsets: MEDLINE
    • Publication Information:
      Publication: <2009->: Amsterdam : Elsevier
      Original Publication: Cambridge, UK : Reproductive Healthcare Ltd.
    • Subject Terms:
      Oocyte Donation* ; Spermatozoa*; Donor Conception/*statistics & numerical data; Adult ; Birth Rate ; Embryo Transfer ; Female ; Humans ; Male ; Middle Aged ; Pregnancy ; Retrospective Studies ; Treatment Failure ; Young Adult
    • Abstract:
      Research Question: Do donor spermatozoa improve IVF outcomes after first oocyte donation failure?
      Design: Retrospective, multicentre study including couples undergoing oocyte donation cycles using autologous or donor spermatozoa after a failed first attempt. Male partners were further characterized as normozoospermic or oligoasthenoteratospermic, i.e. fewer than 5 million motile progressive spermatozoa in the ejaculate. The main outcomes measured were live birth rate (LBR) per embryo transfer, LBR per number of embryos transferred, and cumulative LBR (CLBR) considering oocytes consumed in the previous donation cycles.
      Results: Analysis comprised 6065 cycles of oocyte donation failure; among these, subgroup analyses by sperm quality comprised 4113 cycles with severe male factor and 1150 cycles with suboptimal/normal spermatozoa. Sperm replacement in the first cycle after failure increased LBR per embryo transfer (OR 2.21, 95% CI 1.7-2.8, P < 0.001) and per number of embryos transferred (OR 2.46, 95% CI 1.9-3.1, P < 0.001) for normospermic and oligoasthenoteratospermic men. Replacement by the third cycle after failure was less beneficial (LBR per embryo transfer: OR 1.35, 95% CI 0.9-2.1, P = 0.16; LBR per embryos transferred: OR 1.33, 95% CI 0.9-2.0, P = 0.186). Kaplan-Meier curves of CLBR per oocyte fertilized with autologous or donor spermatozoa were statistically different (P < 0.001) and demonstrate how each additional oocyte may affect success based on sperm source (donor/autologous).
      Conclusions: Donor spermatozoa improved outcomes when used after an initial failed oocyte donation cycle. The CLBR curves can be used to determine the cumulative chances of live birth using either autologous or donor spermatozoa, providing guidance on when to replace spermatozoa.
      (Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
    • Contributed Indexing:
      Keywords: Cumulative live birth rate; IVF; Non-severe male factor; Oocyte donation; Severe male factor; Sperm donation
    • Publication Date:
      Date Created: 20210303 Date Completed: 20211129 Latest Revision: 20211129
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.rbmo.2021.01.004
    • Accession Number:
      33653652