In-vitro fertilization treatment for severe male factor: the fertilizationpotential of immotile spermatozoa obtained by testicular extraction

A retrospective analysis in 50 couples of 53 cycles of intracytoplasmic spe rm injection (ICSI) with immotile spermatozoa from testicular-retrieved spe rmatozoa was performed to evaluate whether total immotile spermatozoa achie ved after testicular sperm extraction could fertilize ova and result in pre gnancies. We assessed the efficacy of ICSI with totally immotile testicular spermatozoa extracted from the testes of azoospermic patients with severe spermatogenic failure (group 1) and compared these results with those from spermatozoa which were recovered after several hours of incubation and were motile (group 2) at the time of injection. In 19 cycles, only totally immo tile spermatozoa were injected at the time of ICSI, For the remaining 34 cy cles, at least one motile spermatozoon was found for injection, The oocyte fertilization rates were 51% for group 1 and 62% for group 2 (P < 0.02). Ei ghteen of 19 cycles in group 1 (90%) and all 34 (100%) cycles in group 2 ha d embryos for replacement. The mean number of embryos per cycle was 5.2 +/- 0.8 and 7.5 +/- 0.9 in groups 1 and 2 respectively; this and the embryo qu ality (cumulative embryo scoring = 40 +/- 8 for group 1 and 50 +/- 7 for gr oup 2), and clinical pregnancy rates (15.8% per oocyte retrieval in group 1 and 23.5% in group 2) were not significantly different between groups. Fer tilization, cleavage and pregnancy can be achieved with intracytoplasmic te sticular sperm injection from patients with immotile spermatozoa, at levels comparable with those of ICSI using motile spermatozoa.