Titre du document / Document title

Indications for corticosteroids prior to epididymal sperm retrieval

Auteur(s) / Author(s)

SHIN D. ⁽¹⁾ ; PALERMO G. D. ⁽²⁾ ; GOLDSTEIN M. ^{(1 3)} ; ROSENWAKS Z. ⁽²⁾ ; SCHLEGEL P. N. ^{(1 3)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ James Buchanan Brady Foundation, Department of Urology, New York, New York, ETATS-UNIS
⁽²⁾ Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, The New York Hospital-Cornell Medical Center, New York, New York, ETATS-UNIS
⁽³⁾ The Population Council, Center for Biomedical Research, New York, New York, ETATS-UNIS

Résumé / Abstract

Objective-To evaluate the effectiveness of low-dose intermittent prednisone treatment designed to reduce antisperm antibodies for men prior to epididymal sperm retrieval and in vitro fertilization. Study Design-This was a retrospective review of 75 subfertile men with reproductive obstruction due to congenital absence of the vas deferens, or other reproductive tract obstruction, who underwent a total of 98 episodes of microsurgical epididymal sperm aspiration (MESA) with in vitro fertilization. Results-For couples in whom the man was pretreated with prednisone, better fertilization rates (39% vs. 21%, P <.0001) and pregnancy rates (48% vs. 26%, p = 0.06) were obtained than in couples in whom the man was not pretreated. The benefit of prednisone treatment was most noticeable for men with preoperatively detectable antisperm antibodies. Prednisone-treated men with preoperative antisperm antibodies showed improved fertilization rates (40% vs. 9%, p = 0.005). Men without antibodies who were treated with prednisone showed a decrement in fertilization rate, from 73% to 24% (fertilizations per oocyte, P <.0005). Success of prednisone treatment could not be correlated with specific assisted-reproduction technique (IVF, PZD, SuZI, or ICSI). Conclusions-Preoperative evaluation of antisperm antibody status and treatment of antibody-positive men prior to epididymal sperm retrieval may play a role in improvement of the fertilization and pregnancy results achieved by centers that provide MESA with assisted reproduction. These results are most important when MESA is performed without the assistance of intracytoplasmic sperm injection. Empiric treatment with prednisone may be detrimental to the fertility of men who have no antisperm antibodies.

Revue / Journal Title

International journal of fertility and menopausal studies   ISSN 1069-3130 

Source / Source

1998, vol. 43, n^o3, pp. 165-170 (19 ref.)

Langue / Language

Anglais

Editeur / Publisher

Medical Science Publishing, Port Washington, NY, ETATS-UNIS  (1993-1996) (Revue)

Mots-clés anglais / English Keywords

In vitro fertilization embryo transfer ; Agenesis ; Vas deferens ; Congenital ; Prednisone ; Chemotherapy ; Treatment ; Antibody ; Semen ; Immunosuppressive agent ; Human ; Male ; Corticosteroid ; Assisted procreation ; Male genital diseases ;

Mots-clés français / French Keywords

Fécondation in vitro transfert embryon ; Agénésie ; Canal déférent ; Congénital ; Prednisone ; Chimiothérapie ; Traitement ; Anticorps ; Sperme ; Immunodépresseur ; Homme ; Mâle ; Corticostéroïde ; Procréation assistée ; Appareil génital mâle pathologie ;

Mots-clés espagnols / Spanish Keywords

Fecundación in vitro transplante embrión ; Agenesia ; Canal deferente ; Congénito ; Prednisona ; Quimioterapia ; Tratamiento ; Anticuerpo ; Esperma ; Inmunodepresor ; Hombre ; Macho ; Corticoesteroide ; Procreación asistida ; Aparato genital macho patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 12201, 35400007714968.0060