ANAHEIM, CA (UroToday.com) - Since it is desirable to have motile sperm available for ICSI and improvements in motility are seen when incubated in media for extended periods, the authors attempted to determine the optimal duration of incubation and culture media to achieve maximum sperm motility. Diagnostic and therapeutic fine needle testicular aspirations were performed on 95 azoospermic men [51 obstructive (OA); 44 non-obstructive (NOA)] cases. The number of non-motile and motile sperm were assessed at collection and following incubation for 24h and 48h in either primary media (PM) or Ham's F10 + protein (F10). The change in motility was analyzed. Initial mean motility was 3% in OA cases and 0% in NOA cases. Motility improved to 20% (24h) and to 25% n(48h) for OA cases and to 5% ( 24h) and 11% ( 48h) for NOA cases. The improvement in motility from 24 to 48 hours was significant for OA cases only (p=0.001). Overall, 47% of samples increased from 24h to 48h while 28% declined and 25% were unchanged.

Incubation in PM or F10 media improves sperm motility with significant improvement noted between 24 and 48h for OA cases. F10 media may provide extra benefit for cases of NOA.

Editorial Comment:
This study attempts to address an important clinical dilemma. The ability to obtain testicular sperm within a 48 hour interval of oocyte acquisition is appealing to the urologist since it allows greater flexibility. The theoretical advantage of 24 or 48 hour incubation is demonstrated in the obstructive azoospermic patients. There does not appear to be any predictable deterioration in motility because as the authors noted 47% of samples increased from 24h to 48h while 28% declined and 25% were unchanged.

David S Morris, Damon E Davis, Rodney L Dunn, Gary D Smith, Dana A Ohl. Ann Arbor, MI.

[ ABST1805 ]

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Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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