Etiology-specific outcomes of intracytoplasmic sperm injection in azoospermic patients.
OBJECTIVE
To assess fertilization, pregnancy, and miscarriage rates after intracytoplasmic sperm injection (ICSI) with epididymal or testicular spermatozoa from different types of azoospermia.


METHODS
Retrospective study.


METHODS
Academic medical center and private fertility center.


METHODS
Two hundred twelve patients underwent 257 ICSI cycles.


METHODS
Cycles of ICSI were divided into four groups according to the etiology of azoospermia: A (nonobstruction), B (postvasectomy), C (congenital obstruction), and D (obstruction due to infection). Testicular sperm aspiration and percutaneous epididymal sperm aspiration were the sperm retrieval methods used for ICSI.


METHODS
Fertilization, pregnancy, and miscarriage rates.


RESULTS
Normal fertilization rates were higher in groups C (67.7%) and B (64.1%) compared with groups A (47.3%) and D (58.9%). Although lower pregnancy rates were seen in group A, no statistical differences were detected among groups. However, the miscarriage rate was higher in group A (45.6%) compared with groups B (25.25%), C (24%), and D (22.58%).


CONCLUSIONS
Although no differences were detected in the pregnancy rates across groups, fertilization and implantation rates were higher in patients with congenital obstruction of the seminal path. The pregnancy rate was higher and the miscarriage rate lower when epididymal sperm was used compared with testicular sperm.
Pasqualotto
Fábio F
FF
Fertility--Center for Assisted Reproduction, São Paulo, SP, Brazil.
Rossi
Lia Mara
LM
Guilherme
Patrícia
P
Ortiz
Valdemar
V
Iaconelli
Assumpto
A
Borges
Edson
E
D000022:Abortion, Spontaneous; D000328:Adult; D004822:Epididymis / Q000166:cytology; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D009845:Oligospermia / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa; D013737:Testis / Q000166:cytology; D016896:Treatment Outcome; D014659:Vasectomy