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Risks of TESE‐ICSI in men with severe oligozoospermia or sperm DNA damage
 Surgical risk of TESE : testicular hemorrhage, hematomas, testicular atrophy (Okada et al., 2002)
 Lower fertilization rate/oocyte injected (Oron et al., 2014)
 Testicular spermatozoa have a higher rate of aneuploidy than ejaculated spermatozoa (Moskovtsev et al., 2012; Vozdova et al., 2012)
 Testicular spermatozoa had incomplete chromatin compaction and are more susceptibility to DNA damage
Zini et al. (2017) Hum Reprod 32, 7‐13 Okada et al. (2002) J Urol 168:1063–7.
Oron et al. (2014) Gynecol Endocrinol 30:103–6. Vozdova et al. (2012) Hum Reprod 27:2233–9. Moskovtsev et al. (2012) Syst Biol Reprod Med 58: 142–8.
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Short abstinence decreases sperm DNA damage
Short abstinence may lower sperm DNA damage
– 3 h had a lower level than 24 h abstinence (Gosalvez et al. 2011)
– Men with high levels of DNA damage decreased to normal in 1‐3 subsequent samples after a 1‐day of abstinence (Pons et al. 2013) .
– 1‐day was better than 5‐ and 7‐day of abstinence (Uppangala et al., 2016)
Sperm from short abstinence had poorer chromatin compaction (aniline blue staining) and are more susceptibility to DNA damage with in vitro incubation (20‐fold  in 6 h) (Uppangala et al., 2016).
Gosalvez et al. (2011) Fertil Steril 96:1083–1086 Pons et al. (2013) JARG 30:1211–1218. Uppangala et al. (2016) PLoS One 1:e0152942
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