title: Etiology-specific outcomes of intracytoplasmic sperm injection in azoospermic patients.
abstract: 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.
authors.affiliation: Fertility--Center for Assisted Reproduction, São Paulo, SP, Brazil.
authors.forename: Fábio F
authors.initials: FF
authors.lastname: Pasqualotto
authors.forename: Lia Mara
authors.initials: LM
authors.lastname: Rossi
authors.forename: Patrícia
authors.initials: P
authors.lastname: Guilherme
authors.forename: Valdemar
authors.initials: V
authors.lastname: Ortiz
authors.forename: Assumpto
authors.initials: A
authors.lastname: Iaconelli
authors.forename: Edson
authors.initials: E
authors.lastname: Borges
mesh_terms: 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