RESULTS OF MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION (MESA) AND TESTICULAR SPERM EXTRACTION (TESE) IN AZOOSPERMIC MEN USING INTRACYTOPLASMIC SPERM INJECTION (ICSI)

The rationale and results of using epididymal and testicular spermatoz oa with intracytoplasmic sperm injection (ICSI) for azoospermic patien ts are reviewed. A total of 128 consecutive ICSI/MESA cycles and a tot al of 120 consecutive ICSI/TESE cycles were performed up to December 1 994. The two-pronuclei fertilization rate per intact oocyte (observed after the injection) was 58% and 60%, respectively, when epididymal an d testicular spermatozoa were used. The embryo transfer rate was simil ar for the two procedures (91% after ICSI/MESA and 90% after ICSI/TESE ). Fifty women became pregnant (positive HCG) when epididymal spermato zoa were used (39% per cycle and 43% per embryo transfer). Similar res ults were observed in the group of patients undergoing ICSI using test icular spermatozoa (36% per cycle and 40% per embryo transfer). These results are comparable to those obtained when ejaculated spermatozoa a re used.