EFFICACY OF INTRACYTOPLASMIC SPERM INJECTION USING TESTICULAR SPERMATOZOA

In patients with obstructive azoospermia in whom standard microsurgica l procedures fail or are unfeasible, the only source of spermatozoa is the testicle, In addition, in some azoospermic patients with severe s permatogenic failure, a few spermatozoa may be present in testicular b iopsy specimens despite high serum follicle stimulating hormone concen trations. In all these cases, intracytoplasmic sperm injection (ICSI) with testicular biopsy-extracted spermatozoa may offer the chance of p regnancy, To assess the efficacy of this procedure, we compared the re sults of two series of ICSI cycles performed during the same time peri od: 21 cycles using testicular biopsy-extracted spermatozoa and 83 cyc les using ejaculated spermatozoa, Mean fertilization rates (59% with t esticular and 68% with ejaculated spermatozoa), mean cleavage rates (9 3% with testicular and 90% with ejaculated spermatozoa), embryo qualit y (77% good quality embryos in the testicular sperm group and 77% in t he ejaculated sperm group) and clinical pregnancy rates (36.8% in the testicular sperm group and 28% in the ejaculated sperm group) were not significantly different in both groups, We conclude that high fertili zation, cleavage and pregnancy rates can be achieved with intracytopla smic testicular sperm injection, reaching levels comparable with those of ICSI using ejaculated spermatozoa.