title: Poor outcome with round spermatid injection in azoospermic patients with maturation arrest.
abstract: OBJECTIVE
  To compare the outcome of intracytoplasmic sperm injection (ICSI) and round spermatid injection (ROSI), both obtained by testicular sperm extraction (TESE), and to compare the results of fresh versus frozen ROSI.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  An IVF unit at a university hospitalPatient(s): Eighteen infertile couples with nonobstructive azoospermia.
  
  
  METHODS
  TESE with ROSI or ICSI of mature spermatozoa into metaphase II oocytes was performed. The resulting embryos were transferred to female partners. The spare round spermatids were frozen.
  
  
  METHODS
  Fertilization and cleavage rates, embryo quality, and clinical pregnancy rates.
  
  
  RESULTS
  Seventeen ROSI cycles and six ICSI cycles were compared. Fertilization rate following ROSI (44.9%) was significantly lower than with ICSI (69%). A significantly higher rate of cleavage arrest occurred following ROSI (40.8%) as compared to ICSI (8.2%). The morphology of embryos resulting from ROSI was significantly poorer. No pregnancies were achieved following ROSI as compared to a 50% clinical pregnancy rate in the ICSI group. The fertilization and cleavage rates following ROSI with fresh versus frozen-thawed spermatids were comparable.
  
  
  CONCLUSIONS
  In azoospermic patients with maturation arrest at the stage of round spermatids the efficiency of ROSI appears to be extremely poor. The role of ROSI in the treatment of nonobstructive azoospermia should be reevaluated.
authors.affiliation: IVF Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Levran
authors.forename: H
authors.initials: H
authors.lastname: Nahum
authors.forename: J
authors.initials: J
authors.lastname: Farhi
authors.forename: A
authors.initials: A
authors.lastname: Weissman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D012189:Retrospective Studies; D012662:Semen Preservation; D020554:Sperm Injections, Intracytoplasmic; D013087:Spermatids