PREGNANCIES AFTER INTRACYTOPLASMIC INJECTION OF SPERM COLLECTED BY FINE-NEEDLE BIOPSY OF THE TESTIS

Objective: To investigate the use of intracytoplasmic sperm injection with sperm collected by fine needle biopsy of the testis as a treatmen t for male genital tract obstruction. Design: Sperm isolated from a fi ne needle biopsy of the testis were used to inseminate oocytes by intr acytoplasmic sperm injection. Setting: A hospital-based tertiary refer ral infertility service. Patients: Case studies of two couples in whom the male partner had a genital tract obstruction. Main Outcome Measur es: Fertilization and pregnancy. Results: In the first ease, 9 oocytes fertilized normally out of 13 injected. After the transfer of fresh ( one cycle) and frozen (four cycles) embryos, a single intrauterine fet al heart pregnancy was achieved. In the second case, five oocytes fert ilized normally from nine oocytes injected; two embryos were transferr ed fresh and three were frozen. A single fetal heart intrauterine gest ation was obtained after the initial transfer of two fresh embryos. Co nclusions: A high normal fertilization rate and pregnancies are possib le with intracytoplasmic sperm injection using sperm collected directl y from the testis. Sperm retrieval by fine needle biopsy offers a viab le alternative to microsurgical aspiration and is also suitable for tr eating patients with intratesticular blockage.