title: [Efficient treatment of severe teratozoospermia by ICSI with testicular spermatozoa: a report of 5 cases].
abstract: OBJECTIVE
  To explore the feasibility of treating severe teratozoospermia (the abnormity rate of ejaculated or epididymal sperm > or = 99%) by intracytoplasmic sperm injection (ICSI) with testicular sperm so as to improve the outcome of assisted reproductive technology.
  
  
  METHODS
  We retrospectively analyzed the clinical data of 5 patients with severe teratozoospermia (epididymal: n=4; ejaculated: n=1) treated by ICSI with sperm from different sources, and compared the rates of fertilization, cleavage, quality embryos, pregnancy and implantation between the testicular and non-testicular sperm groups.
  
  
  RESULTS
  Four ongoing clinical pregnancies were achieved by ICSI with testicular sperm, but none with ejaculated (or epididymal) sperm. The rates of pregnancy and implantation were significantly higher in the testicular than in the non-testicular sperm group (P < 0.01), and there were no significant differences in the rates of fertilization, cleavage and quality embryos between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  ICSI with testicular sperm could efficiently improve the therapeutic outcome for men with severe teratozoospermia.
authors.affiliation: Center of Reproductive Medicine, Drum Tower Hospital Affiliated to Nanjing University School of Medicine, Nanjing, Jiangsu 210008, China. xzpbio@hotmail.com
authors.forename: Zhi-peng
authors.initials: ZP
authors.lastname: Xu
authors.forename: Hai-xiang
authors.initials: HX
authors.lastname: Sun
authors.forename: Ning-yuan
authors.initials: NY
authors.lastname: Zhang
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Zhi-peng
authors.initials: ZP
authors.lastname: Xu
mesh_terms: D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000002:abnormalities*; D013737:Testis; D016896:Treatment Outcome