Intracytoplasmic sperm injection for treatment of non-obstructive azoospermia

• Published in: Gynecological endocrinology Vol. 11; no. 5; pp. 335 - 339
• Main Authors: Abuzeid, M. I., Sasy, M. A., Salem, H. H.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 1997; Taylor & Francis
• Subjects: Adult; Cryopreservation; Cytoplasm; Embryo Transfer; Female; Fertilization in Vitro - methods; Humans; Infertility, Male - etiology; Infertility, Male - therapy; Intracytoplasmic Sperm Injection; Male; Microinjections; non-Obstructive Azoospermia; Oligospermia - complications; Oligospermia - pathology; Pregnancy; Pregnancy Outcome; Sperm Motility; Spermatozoa - physiology; Testicular Sperm Extraction; Testis - pathology
• ISSN: 0951-3590; 1473-0766
• DOI: 10.3109/09513599709152558

Four cases from a tertiary care teaching medical center were studied to assess the potential of sperm extraction, fertilization and the establishment of pregnancy in couples with non-obstructive azoospermia. Four couples with non-obstructive azoospermia underwent intracytoplasmic sperm injection after testicular sperm extraction. Multiple small biopsies were obtained from each testis under general anesthesia in search for sperm, and to establish a histologic diagnosis. The histopathology includes incomplete maturation arrest, hypospermatogenesis, germ cell hypoplasia and incomplete tubular sclerosis. Testicular sperm extraction resulted in the retrieval ofimmotile sperm from three patients, and a few motile sperm from one patient. Of 60 oocytes which were injected with testicular sperm, 32 (53.3%) fertilized and 21 of these (84.4%) cleaved. Twelve embryos were transferred to three patients and the remaining 15 embryos were cryopreserved. In one patient, no embryos resulted. One clinical pregnancy was established and a normal female infant, weighing 7 lbs 11 oz, was delivered vaginally in August 1996. This study shows that sperm can be extracted from patients with nonobstructive azoospermia when multiple biopsies are obtained. Fertilization, cleavage, clinical pregnancy and delivery of normal babies can be achieved using intracytoplasmic injection of extracted sperm.