Im. Ghazzawi et al., Reproductive capacity of round spermatids compared with mature spermatozoain a population of azoospermic men, HUM REPR, 14(3), 1999, pp. 736-740
The present study aims to evaluate the injection of testicular round sperma
tids from patients with complete failure of spermiogenesis compared with th
at of mature epididymal and testicular spermatozoa, Over a period of 8 mont
hs, 188 azoospermic patients were evaluated with a view to their inclusion
in our intracytoplasmic sperm injection (ICSI) programme. All patients had
had a previous testicular biopsy; 38 had pure obstructive azoospermia, whil
e 150 had non-obstructive azoospermia, Mature spermatozoa were found in 93
patients, whereas spermatozoa were entirely absent, with a predominance of
round spermatids in 87, In eight patients, spermatids could not be found an
d therefore their cycles were cancelled. There was an early appearance of t
he two pronuclei stage in the round spermatid group compared with the matur
e spermatozoa group of patients (10.2 and 16 h respectively). The fertiliza
tion rate was also significantly lower (P = 0.00001) in the round spermatid
group. The numbers of embryos developed and of embryo transfers in the rou
nd spermatid injection group were significantly lower compared with the mat
ure spermatozoa injection group (P = 0.05 and 0.0001 respectively). No preg
nancies resulted from round spermatid injection, while 18 pregnancies were
achieved from the injection of mature spermatozoa, In conclusion, injection
of round spermatids from patients with complete failure of spermiogenesis
resulted in a significantly lower fertilization rate and a higher developme
ntal arrest compared with injection of mature spermatozoa, With no pregnanc
ies achieved, one may question the unusual variability of reported success
rates and stress the need for further research in order to improve the outc
ome of this novel technique.