title: Advanced surgical sperm recovery is a viable option for intracytoplasmic sperm injection in patients with obstructive or nonobstructive azoospermia.
abstract: OBJECTIVE
  To determine whether advanced sperm retrieval is appropriate in cases of obstructive and nonobstructive azoospermia.
  
  
  METHODS
  Prospective controlled study.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Men with obstructive and nonobstructive azoospermia, and their partners.
  
  
  METHODS
  Surgical sperm retrieval followed by intracytoplasmic sperm injection (ICSI) after 4 or 48 hours.
  
  
  METHODS
  Fertilization and pregnancy rates.
  
  
  RESULTS
  Advanced and fresh surgical sperm recoveries for ICSI were performed in 54 and 230 cycles, respectively. Patient demographics and cycle parameters were comparable. Two hundred forty-one (56.3%) of 428 injected eggs in the advanced retrieval group were fertilized, compared with 955 (56.6%) of 1,686 eggs in the fresh retrieved group (P=.94). There was no statistically significant difference in the pregnancy rates per ET between groups: 38.2% (18 of 47) in the advanced retrieval group and 39.9% (73 of 183) in the fresh sperm recovery group (P=.97).
  
  
  CONCLUSIONS
  Testicular and epididymal sperm recovery can be safely performed 48 hours before ICSI. This facilitates planning, and, in cases of failure to retrieve sperm, hCG administration and ovum pick-up can be canceled, thereby reducing costs and eliminating the risk of ovarian hyperstimulation.
authors.affiliation: Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. jaroudi@kfshrc.edu.sa
authors.forename: K
authors.initials: K
authors.lastname: Jaroudi
authors.forename: S
authors.initials: S
authors.lastname: Coskun
authors.forename: J
authors.initials: J
authors.lastname: Hollanders
authors.forename: S
authors.initials: S
authors.lastname: Al-Hassan
authors.forename: H
authors.initials: H
authors.lastname: Al-Sufayan
authors.forename: A
authors.initials: A
authors.lastname: Atared
authors.forename: T
authors.initials: T
authors.lastname: Merdad
mesh_terms: D001706:Biopsy; D004624:Embryo Transfer; D004822:Epididymis / Q000166:cytology / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008297:Male; D008845:Microinjections; D009845:Oligospermia / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D013048:Specimen Handling / Q000379:methods*; D013094:Spermatozoa; D013396:Suction; D013737:Testis / Q000166:cytology / Q000601:surgery