title: Does the outcome of ICSI in cases of obstructive azoospermia depend on the origin of the retrieved spermatozoa or the cause of obstruction? A comparative analysis.
abstract: OBJECTIVE
  To compare the outcomes of intracytoplasmic sperm injection (ICSI) for men with obstructive azoospermia and normal spermatogenesis, according to the use of epididymal or testicular spermatozoa and the cause of obstruction.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Private infertility center.
  
  
  METHODS
  A detailed chart review of a cohort of 1,121 men with obstructive azoospermia who underwent intracytoplamic sperm injection (ICSI) was performed.
  
  
  METHODS
  Patients were grouped according to the origin of spermatozoa: epididymal (n=331) or testicular (n=790). They were further classified into two subgroups according to the cause of obstruction: congenital bilateral absence of vas deferens (CBAVD; n=434), and other causes of obstruction (n=687).
  
  
  METHODS
  Fertilization, clinical pregnancy, and miscarriage rates.
  
  
  RESULTS
  Fertilization (64.2% vs. 68.0%), clinical pregnancy (42.3% vs. 43.2%), and miscarriage (17.6% vs. 18.4%) rates did not differ between epididymal spermatozoa and testicular spermatozoa, respectively. Fertilization, clinical pregnancy, and miscarriage rates were also similar in the patients with CBAVD or due to other causes of obstruction.
  
  
  CONCLUSIONS
  The source of sperm used for ICSI in cases of obstructive azoospermia and the etiology of the obstruction do not affect the outcome in terms of fertilization, pregnancy, or miscarriage rates.
authors.affiliation: Assisted Reproduction and Gynecology Centre, London, United Kingdom. ahmedivf@hotmail.com
authors.forename: Ahmed
authors.initials: A
authors.lastname: Kamal
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Fahmy
authors.forename: Ragaa
authors.initials: R
authors.lastname: Mansour
authors.forename: Gamal
authors.initials: G
authors.lastname: Serour
authors.forename: Mohamed
authors.initials: M
authors.lastname: Aboulghar
authors.forename: Liliana
authors.initials: L
authors.lastname: Ramos
authors.forename: Jan
authors.initials: J
authors.lastname: Kremer
mesh_terms: D000328:Adult; D000368:Aged; D053713:Azoospermia / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004822:Epididymis / Q000473:pathology; D005260:Female; D006801:Humans; D007246:Infertility / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval / Q000009:adverse effects*; D013733:Testicular Diseases / Q000150:complications / Q000209:etiology; D013737:Testis / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult