title: Male and female factors that influence ICSI outcome in azoospermia or aspermia.
abstract: Factors that influenced the clinical results of 220 first-attempt intracytoplasmic sperm injection (ICSI) cycles with testicular spermatozoa were evaluated in 107 men with non-obstructive azoospermia, 72 with obstructive azoospermia and 41 with aspermia. Linear and logistic regression analysis showed that the fertilization rate depended positively on Johnsen score (P = 0.016) and on the type of ovarian stimulation: a higher fertilization rate was observed after ovarian stimulation with agonist and recombinant FSH than after stimulation with agonist and urinary menopausal gonadotrophin (P = 0.026). Embryo development to the blastocyst stage was predicted positively by the number of injected oocytes (P = 0.016) and negatively by male FSH concentration (P = 0.019). A higher proportion of blastocysts developed after the use of frozen-thawed spermatozoa in comparison to fresh spermatozoa (P = 0.034). Embryo development to the blastocyst stage influenced pregnancy (P = 0.002) and live birth outcomes (P = 0.005); live birth was also predicted by female age (P = 0.046). Embryo culture to day 5 in comparison to day 2 did not provide higher live birth rates. In azoospermia/aspermia, the ICSI outcome depends on both male factors (FSH, Johnsen score, sperm status and motility) and female factors (age, number of injected oocytes).
authors.affiliation: Andrology Centre, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia. branko.zorn@kclj.si
authors.forename: Branko
authors.initials: B
authors.lastname: Zorn
authors.forename: Irma
authors.initials: I
authors.lastname: Virant-Klun
authors.forename: Saso
authors.initials: S
authors.lastname: Drobni
authors.forename: Jasna
authors.initials: J
authors.lastname: Sinkovec
authors.forename: Helena
authors.initials: H
authors.lastname: Meden-Vrtovec
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D053714:Aspermia / Q000175:diagnosis* / Q000628:therapy; D053713:Azoospermia / Q000175:diagnosis* / Q000628:therapy; D046149:Embryo Culture Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D053625:Sperm Retrieval; D016896:Treatment Outcome