Epididymal and Testicular Sperm for Intracytoplasmic Sperm Injection in the Treatment of Azoospermia.

Abstract

The technique of assisted reproduction have recently become the most effective methods of treatment of infertility ; TESE (testicular sperm extraction) and MESA (microsurgical epididymal sperm aspiration). It has been increasingly successful, even above the average efficiency of classical IVF (in vitro fertilization). This study investigated that the sperm retrieval success rates, fertilization rates, and pregnancy rates of MESA and TESE in cases of azoospermia. Forty-six infertile couples with obstructive and non- obstructive azoospermia were included in this study. Twenty-three cycles each of MESA-ICSI and TESE-ICSI cycles were performed. A difference in the normal two-pronuclear (PN) fertilization rate was found between the two groups : 60% for epididymal spermatozoa and 33% for testicular biopsy spermatozoa. The cleavage rates were almost the same for epididymal 83% and testicular spermatozoa 90%. The ongoing pregnancy rate in this series were 35% and 19% respectively. Clinical data have confirmed that fertilization rate and pregnancy rate are not lower than conventional IVF. We conclude that epididymal spermatozoa and testicular spermatozoa gain different fertilization and ongoing pregnancy rates using ICSI. This technique could provide a useful alternative for the management of infertile men with azoospermia when compared with conventional IVF.