OUTCOME OF IN-VITRO FERTILIZATION AND INTRACYTOPLASMIC INJECTION OF EPIDIDYMAL AND TESTICULAR SPERM EXTRACTED FROM PATIENTS WITH OBSTRUCTIVE AND NONOBSTRUCTIVE AZOOSPERMIA

Objective: To evaluate IVF outcome after epididymal and testicular spe rm retrieval in patients with obstructive or nonobstructive azoospermi a. Design: Retrospective clinical analysis. Setting: Public university -affiliated IVF unit. Patient(s): One hundred twenty-three azoospermic patients (178 cycles). Intervention(s): Sixty-three patients (103 cyc les) with obstructive azoospermia (group 1) underwent either epididyma l or testicular sperm retrieval, and 60 patients (75 cycles) with nono bstructive azoospermia (group 2) underwent testicular sperm retrieval combined with IVF treatment. Mature oocytes were fertilized using intr acytoplasmic sperm injection. After sperm preparation, supernumerary s permatozoa were cryopreserved. Main Outcome Measure(s): Oocyte fertili zation rate and clinical pregnancy rate (PR). Result(s): The oocyte fe rtilization rate was 48.4% (534/1,104) in group 1 and 41.5% (312/751) in group 2 (not significant [NS] difference). A total of 100 cycles (9 7.1%) and 62 cycles (82.7%) in the obstructive and nonobstructive grou ps, respectively, had embryos for replacement (NS difference). The cli nical PRs per ET cycle were 24% (24/100) and 17.7% (11/62) in the two groups, respectively. Oocyte fertilization rates, when fresh (46.4%) o r frozen-thawed (41.8%) spermatozoa were used, were not significantly different in the two groups. The PR when fresh sperm were used was 23. 6% (30/127), versus 14.3% (5/35) when frozen sperm were used (NS diffe rence). The PR for women aged less than or equal to 35 years was simil ar to that for women >35 years of age (20.7% or 29/140 and 18.2% or 4/ 25, respectively). Conclusion(s): Epididymal and testicular sperm obta ined in azoospermic patients can fertilize oocytes successfully and ma y lead to high fertilization rates and PRs. Freezing of these spermato zoa does not reduce the outcome of treatment significantly. (C) 1998 b y American Society for Reproductive Medicine.