INTRACYTOPLASMIC SPERM INJECTION FOR TREATMENT OF NONOBSTRUCTIVE AZOOSPERMIA

Four cases from a tertiary care teaching medical center were studied t o assess the potential of sperm extraction, fertilization and the esta blishment of pregnancy in couples with non-obstructive azoospermia. Fo ur couples with non-obstructive azoospermia underwent intracytoplasmic sperm injection after testicular sperm extraction. Multiple small bio psies were obtained from each testis under general anesthesia in searc h for sperm, and to establish a histologic diagnosis. The histopatholo gy includes incomplete maturation arrest, hypospermatogenesis, germ ce ll hypoplasia and incomplete tubular sclerosis. Testicular sperm extra ction resulted in the retrieval of immotile sperm from three patients, and a few motile sperm from one patient. Of 60 oocytes which were inj ected with testicular sperm, 32 (53.3%) fertilized and 27 of these (84 .4%) cleaved. Twelve embryos were transferred to three patients and th e remaining 15 embryos were cryopreserved. In one patient, no embryos resulted. One clinical pregnancy was established and a normal female i nfant, weighing 7 lbs 11 oz, was delivered vaginally in August 1996. T his study shows that sperm can be extracted from patients with non-obs tructive azoospermia when multiple biopsies are obtained. Fertilizatio n, cleavage, clinical pregnancy and delivery of normal babies can be a chieved using intracytoplasmic injection of extracted sperm.