[Intracytoplasmic sperm injection for obstructive azoospermia].
OBJECTIVE
To sum up the experience in the treatment of obstructive azoospermia by intracytoplasmic sperm injection (ICSI).


METHODS
We retrospectively analyzed 107 cases of obstructive azoospermia treated by ICSI in our center from Jan. 2006 to Dec. 2008, and compared the rates of fertilization, cleavage and pregnancy between the patients with congenital bilateral absence of vas deferens (CBAVD) and those with non-CBAVD.


RESULTS
A total of 949 oocytes were injected for the 107 patients undergoing ICSI, of which 678 (71.4%) were fertilized and 605 (89.2%) cleaved, with 44 pregnancies (41.4%). Of the 442 oocytes injected for the 49 patients with CBAVD, 308 (69.6%) were fertilized and 279 (90.6%) cleaved, with 27 pregnancies (55.1%), and of the 507 oocytes injected for the 58 cases induced by inflammation or surgery, 370 (72.9%) were fertilized and 326 (88.1%) cleaved, with 17 pregnancies (29.3%). The rate of pregnancy was significantly higher in the CBAVD than in the non-CBAVD group (P < 0.01), but there were no significant differences in the rates of fertilization and cleavage between the two groups (P > 0.05).


CONCLUSIONS
PESA or TESE combined with ICSI is an effective approach to the treatment of male infertility induced by obstructive azoospermia, which may achieve a higher rate of pregnancy in patients with CBAVD than in those with non-CBAVD. Inflammation or surgery may not only cause the obstruction of the deferent duct, but also affect sperm quality, and consequently reduce the potentiality of embryonic development.
Center of Reproductive Medicine, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110003, China. nkdoctor@sj-hospital.org
Qiang
Q
Du
Da-Lei
DL
Yang
Bo-Chen
BC
Pan
Li-Xia
LX
He
Xiu-Xia
XX
Wang
Yong-Sheng
YS
Song
Bin
B
Wu
D000328:Adult; D053713:Azoospermia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D016896:Treatment Outcome