Intracytoplasmic sperm injection for treatment of non-obstructive azoospermia.
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 of immotile 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 27 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 non-obstructive azoospermia when multiple biopsies are obtained. Fertilization, cleavage, clinical pregnancy and delivery of normal babies can be achieved using intracytoplasmic injection of extracted sperm.
Abuzeid
M I
MI
Hurley Medical Center, Department of Obstetrics and Gynecology, Flint, Michigan, USA.
Sasy
M A
MA
Salem
H H
HH
D000328:Adult; D015925:Cryopreservation; D003593:Cytoplasm; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy*; D008297:Male; D008845:Microinjections; D009845:Oligospermia / Q000150:complications* / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D013081:Sperm Motility; D013094:Spermatozoa / Q000502:physiology; D013737:Testis / Q000473:pathology