Testicular and epididymal sperm in a microinjection program: methods of retrieval and results.
OBJECTIVE
To describe the methods of collection and laboratory preparation of epididymal and testicular sperm; to compare the fertilization and pregnancy rates; and to establish prognostic factors.


METHODS
Retrospective analysis.


METHODS
Academic reproductive medicine clinic.


METHODS
One hundred twelve consecutive microinjection cycles in 80 patients using either epididymal or testicular sperm.


METHODS
Sperm were collected by microepididymal sperm aspiration, open testicular biopsy, or fine needle tissue aspiration testicular biopsy.


METHODS
Fertilization rate, implantation, and clinical pregnancy rates.


RESULTS
The fertilization rate was higher with epididymal sperm (67%) than with testicular sperm (50%). Implantation rates (fetal hearts per embryo, testicular: 11%, epididymal: 8%) and pregnancy rates (clinical pregnancy per oocyte collection procedure, testicular: 25%, epididymal: 29%) were not significantly different with epididymal and testicular sperm. Multiple regression analysis showed that normal fertilization rates were significantly lower with testicular sperm, immotile sperm, and severe spermatogenic disorders.


CONCLUSIONS
Although fertilization rates are significantly lower with testicular sperm, higher implantation rates resulted in equivalent pregnancy rates. Thus, testicular aspiration of sperm for intracytoplasmic sperm injection is a simple, inexpensive method of sperm retrieval in cases of azoospermia resulting from genital tract obstruction or severe spermatogenic disorder.
Watkins
W
W
Reproductive Biology Unit, Royal Women's Hospital, Carlton, Victoria, Australia.
Nieto
F
F
Bourne
H
H
Wutthiphan
B
B
Speirs
A
A
Baker
H W
HW
D001706:Biopsy; D001707:Biopsy, Needle; D006063:Chorionic Gonadotropin / Q000097:blood; D015925:Cryopreservation; D004624:Embryo Transfer; D004622:Embryo, Mammalian; D004822:Epididymis; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D008845:Microinjections; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D012099:Reproductive Techniques; D012189:Retrospective Studies; D013094:Spermatozoa / Q000166:cytology*; D013737:Testis
D006063:Chorionic Gonadotropin