[Microsurgical epididymal sperm aspiration (MESA), testicular biopsy and intracytoplasmic sperm injection (ICSI) in the treatment of male infertility].
OBJECTIVE
To assess if ICSI using epididymal or testicular spermatozoa is effective in the treatment of couples with male factor infertility.


METHODS
56 couples suffering from male infertility underwent a total of 88 treatment cycles of ICSI, in combination with microsurgical epididymal sperm aspiration (MESA): 62 cycles, or testicular sperm retrieval: 26 cycles.


RESULTS
Overall, fertilization rate was 63% per injected metaphase II oocyte. In MESA group, fertilization rate was 64% compared to 61% embryos in testicular sperm aspiration. The overall pregnancy rate was 26% per started ICSI cycle. Pregnancy rates were also similar in both group: 24% for MESA and 32% for testicular sperm extraction. 9 pregnancy (41%) were obtained using cryopreserved epididymal sperm (6 cases) or testicular sperm (3 cases).


CONCLUSIONS
ICSI combined with epididymal or testicular sperm achieved a high fertilization and pregnancy rate. It constitutes an efficient alternative in the treatment of men suffering of testicular failure or azoospermia not amenable to surgical reconstruction.
el Khader
K
K
Service d'Urologie, Hôpital Pontchaillou, Rennes, France.
Guillé
F
F
Karmouni
T
T
Griveau
J F
JF
Le Lannou
D
D
Lobel
B
B
D000328:Adult; D001706:Biopsy; D015925:Cryopreservation; D003627:Data Interpretation, Statistical; D004822:Epididymis / Q000166:cytology* / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D008845:Microinjections; D008866:Microsurgery; D009845:Oligospermia; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa; D013737:Testis / Q000166:cytology*