Outcome of repeated testicular sperm extraction and ICSI in patients with non-obstructive azoospermia

• Published in: Middle East Fertility Society journal Vol. 9; no. 1
• Main Author: Ahmed Kamal, Ibrahim Fahmy, Ragaa Mansour, Ahmed Abou-Setta, Gamal Serour, Mohamed Aboulghar
• Format: Journal Article
• Language: English
• Published: Middle East Fertility Society 09-05-2006
• Subjects: Repeated TESE, Intracytoplasmic sperm injection, sperm retrieval rate
• ISSN: 1110-5690

Objective: To evaluate the outcome of repeated TESE/ICSI, in patients
with non-obstructive azoospermia, to collect sufficient information for
adequate counseling of the patients. Design: Retrospective study
Setting:The Egyptian IVF-ET center Materials and Methods: 41 patients
suffering from non-obstructive azoospermia underwent 59 repeated
TESE/ICSI cycles. All of the patients had repeated TESE/ICSI because of
failure to achieve pregnancy (n=30), previous abortion (n=3), or
because they wanted another child (n=8). Eleven patients repeated the
procedure more than once. At each procedure multiple small biopsies
were taken from each testicle. The interval between the repetitions of
TESE was at least six months. Main Outcome Measures: Sperm retrieval
rate in each repeated trial, and the clinical pregnancy rate per ICSI
cycle Results: During repeated TESE, the mean sperm retrieval rate was
91.5%. Patients were divided into two groups according to previous
pregnancy in the first trial. In group 1, (n = 11) pregnancy occurred
in the first trial. They underwent 16 TESE/ICSI repeated cycles. Of
these, 9 of them became pregnant a second time (PR 56.3 %). On the
other hand the 30 patients who had failed to achieve pregnancy in the
first trial (Group 2), underwent 43 repeated cycles. Of these only 7
became pregnant in the following trials (16.3 %). This difference is
statistically significant (χ2 9.59, P< 0.05). Conclusion: In
patients with non-obstructive azoospermia, when spermatozoa were
retrieved in the first TESE/ICSI cycle, the sperm recovery rate during
repeated TESE trials is quite high in our study (91.5%). Previous
pregnancy is a good prediction for a second pregnancy in the subsequent
trials.