Reply of the Authors
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REPLY OF THE AUTHORS: We appreciate Dr. Ciray's interest in our article, ‘‘Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men’’ (1), and his insightful remarks. Dr. Ciray's first comment relates to data regarding miscarriages and deliveries achieved per patient. Analyzing our data per patient, we may state that out of 17 patients, 5 patients achieved one pregnancy and delivery; 4 patients achieved two pregnancies each, and two pregnancies ended by early spontaneous abortion (ESA); and 4 patients achieved three pregnancies each, six ending with ESA. Using sperm from extended sperm preparation in these 17 patients, 6 patients achieved a singleton pregnancy and delivery; 2 patients had an ESA. In total, six of the eight patients who achieved pregnancy using sperm from extended sperm preparation delivered. Using sperm from testicular sperm extraction in these 17 patients, 4 patients achieved a singleton pregnancy; 3 delivered, and one pregnancy ended in ESA; 1 patient had two singleton pregnancies ending with ESA; 3 patients had two singleton pregnancies, and one ended in ESA; 4 patients had twin pregnancies and deliveries; 1 patient had three singleton pregnancies, and one ended in ESA. In total, 10 of the 12 patients who achieved pregnancy using sperm from TESE delivered. Seven patients achieved a pregnancy after using both sperm sources. Four patients achieved no pregnancy at all after using both sperm sources. Because the number of patients is rather small, analysis of the data by patient is without power for meaningful statistics. Regarding the second remark, indeed our patients keep faith in our clinic. An average of six treatment cycles over 2 years is not uncommon in Israeli IVF units, because all treatments are covered by the mandatory health insurance for Israeli citizens. Actually our routine is to allow patients to undergo full IVF treatments every other cycle, if they wish. Ido Ben-Ami, M.D., Ph.D. Shevach Friedler, M.D. IVF and Infertility Unit, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel March 31, 2013 http://dx.doi.org/10.1016/j.fertnstert.2013.04.006 REFERENCE 1. Ben-Ami I, Raziel A, Strassburger D, Komarovsky D, Ron-El R, Friedler S. Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men. Fertil Steril 2013;99: 1867–71. e20 VOL. 99 NO. 7 / JUNE 2013 LETTER TO THE EDITOR
Transcript of Reply of the Authors
LETTER TO THE EDITOR
REPLY OF THE AUTHORS: We appreciate Dr. Ciray'sinterest in our article, ‘‘Intracytoplasmic sperm injectionoutcome of ejaculated versus extracted testicularspermatozoa in cryptozoospermic men’’ (1), and his insightfulremarks. Dr. Ciray's first comment relates to dataregarding miscarriages and deliveries achieved per patient.Analyzing our data per patient, we may state that out of17 patients, 5 patients achieved one pregnancy anddelivery; 4 patients achieved two pregnancies each, and twopregnancies ended by early spontaneous abortion (ESA);and 4 patients achieved three pregnancies each, six endingwith ESA.
Using sperm from extended sperm preparation in these17 patients, 6 patients achieved a singleton pregnancy anddelivery; 2 patients had an ESA. In total, six of the eightpatients who achieved pregnancy using sperm from extendedsperm preparation delivered.
Using sperm from testicular sperm extraction in these17 patients, 4 patients achieved a singleton pregnancy;3 delivered, and one pregnancy ended in ESA; 1 patient hadtwo singleton pregnancies ending with ESA; 3 patients hadtwo singleton pregnancies, and one ended in ESA; 4 patientshad twin pregnancies and deliveries; 1 patient had threesingleton pregnancies, and one ended in ESA. In total, 10 ofthe 12 patients who achieved pregnancy using sperm fromTESE delivered.
e20
Seven patients achieved a pregnancy after using bothsperm sources. Four patients achieved no pregnancy at allafter using both sperm sources. Because the number ofpatients is rather small, analysis of the data by patient iswithout power for meaningful statistics.
Regarding the second remark, indeed our patients keepfaith in our clinic. An average of six treatment cycles over2 years is not uncommon in Israeli IVF units, because alltreatments are covered by the mandatory health insurancefor Israeli citizens. Actually our routine is to allow patientsto undergo full IVF treatments every other cycle, if they wish.
Ido Ben-Ami, M.D., Ph.D.Shevach Friedler, M.D.
IVF and Infertility Unit, Assaf Harofeh Medical Center,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv,
Israel
March 31, 2013
http://dx.doi.org/10.1016/j.fertnstert.2013.04.006
REFERENCE1. Ben-Ami I, Raziel A, Strassburger D, Komarovsky D, Ron-El R, Friedler S.
Intracytoplasmic sperm injection outcome of ejaculated versus extractedtesticular spermatozoa in cryptozoospermic men. Fertil Steril 2013;99:1867–71.
VOL. 99 NO. 7 / JUNE 2013
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