PREGNANCY IN AN AZOOSPERMIC PATIENT WITH MARKEDLY ELEVATED SERUM FOLLICLE-STIMULATING-HORMONE LEVELS

Objective: To assess the possibility of achieving a pregnancy in an az oospermic patient with markedly elevated serum FSK level. Design: A ca se report. Setting: In vitro fertilization program at the Institute Va lenciano de Infertilidad. Patient: An azoospermic patient with small t estes and serum FSH level (38.7 mIU/mL) higher than three times normal . Testicular biopsy revealed Sertoli cell-only syndrome with focal spe rmatogenesis. Interventions: Intracytoplasmic microinjection of testic ular tissue-extracted spermatozoa. Main Outcome Measurements: Fertiliz ation rate, cleavage rate, clinical pregnancy. Results: Eight of 11 (7 3%) intact-oocytes showed two pronuclei. All of them cleaved normally. Four embryos were replaced into the uterine cavity and the other four were cryopreserved. A twin clinical pregnancy was achieved. Conclusio n: Spermatozoa may be present in testicular biopsy specimens of azoosp ermic patients with severe spermatogenic failure despite markedly elev ated serum FSH level. These patients can be fertile after intracytopla smic testicular sperm microinjection.