title: [Intracytoplasmic sperm injection (ICSI) in the management of azoospermia].
abstract: OBJECTIVE
  The objective of this study was to analyse all attempts of ICSI performed in our centre between 1995 and 1997 with surgically harvested sperm for the treatment of secretory and excretory azoospermia.
  
  
  METHODS
  71 infertile couples, in which the man suffered from secretory (n = 8) or excretory azoospermia (n = 63), were managed with 94 attempts of ICSI.
  
  
  RESULTS
  ICSI was able to be performed 85 times with 82 embryo transfers resulting in 29 clinical pregnancies. The clinical pregnancy rate per ICSI attempt was comparable with sperm obtained on the day of ICSI or previously harvested and frozen (30.5% and 31.4% respectively). The clinical pregnancy rate per ICSI attempt was 33.3% for testicular sperm (n = 18), and 30.3% for epididymal sperm (n = 76). Twenty-seven clinical pregnancies (32.1%) were obtained for men with excretory azoospermia (47.2% for vas deferens agenesis and 20.8% for acquired urinary tract obstruction, p = 0.01), and 2 (20%) for men with secretory azoospermia.
  
  
  CONCLUSIONS
  ICSI can achieve pregnancy in infertile couples in whom no other solution can be considered. Cryopreservation allows surgical harvesting to be dissociated from ICSI without decreasing the pregnancy rate, justifying freezing of sperm during any surgical procedure on the seminal tract. The better results obtained in congenital excretory azoospermia compared to acquired obstructions, usually post-infectious, suggest a harmful effect of infection on the quality of sperm.
authors.affiliation: Service d'Urologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France.
authors.forename: V
authors.initials: V
authors.lastname: Izard
authors.forename: N
authors.initials: N
authors.lastname: Thiounn
authors.forename: C
authors.initials: C
authors.lastname: Poirot
authors.forename: A
authors.initials: A
authors.lastname: Bouker
authors.forename: S
authors.initials: S
authors.lastname: Epelboin
authors.forename: J R
authors.initials: JR
authors.lastname: Zorn
authors.forename: P
authors.initials: P
authors.lastname: Jouannet
authors.forename: B
authors.initials: B
authors.lastname: Debré
authors.forename: A
authors.initials: A
authors.lastname: Jardin
authors.forename: J P
authors.initials: JP
authors.lastname: Wolf
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008297:Male; D008845:Microinjections; D008875:Middle Aged; D009845:Oligospermia / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
vernacular_title: L'injection intra cytoplasmique de spermatozoïdes (ICSI) dans la prise en charge des azoospermies.