TESTICULAR NEEDLE-BIOPSY, OPEN BIOPSY, EPIDIDYMAL ASPIRATION AND INTRACYTOPLASMIC SPERM INJECTION IN OBSTRUCTIVE AZOOSPERMIA

Testicular or epididymal spermatozoa were obtained for in-vitro fertil ization and intracytoplasmic sperm injection (ICSI) in 27 cycles out o f 33 (in six men the azoospermia proved to have testicular causes). Te sticular needle biopsy carried out in addition to surgical open biopsy proved to be an effective method to obtain spermatozoa for ICSI from patients with obstructive azoospermia. Thus it might be possible to re place scrotal operations by simple needle biopsies. Embryos resulting from ICSI with testicular spermatozoa were used in 19 transfers that r esulted in six pregnancies. One pregnancy resulted from six embryo tra nsfers from ICSI after microsurgical-epididymal sperm aspiration (MESA ). The normal fertilization rates with testicular (37.3%) and MESA spe rmatozoa (53.7%) did not differ significantly from each other, but wit h testicular spermatozoa the rate was significantly lower than that ob tained with ejaculated spermatozoa and ICSI (59.7%) in the matched cou ples. The abnormal fertilization of oocytes with one pronucleus was si gnificantly higher with testicular spermatozoa than with ejaculated sp ermatozoa in the control couples.