title: Intracytoplasmic sperm injection outcome of ejaculated versus extracted testicular spermatozoa in cryptozoospermic men.
abstract: OBJECTIVE
  To compare intracytoplasmic sperm injection (ICSI) outcome of patients with cryptozoospermia after use of ejaculated versus testicular sperm in different cycles of the same patients.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University-affiliated infertility center.
  
  
  METHODS
  A total of 17 patients with cryptozoospermia who underwent a total of 116 ICSI cycles.
  
  
  METHODS
  The patients initially underwent several ICSI cycles using ejaculated sperm (n = 68, 58.6%) that were followed by ICSI cycles using testicular sperm (n = 48, 41.4%).
  
  
  METHODS
  Fertilization rate, pregnancy rate (PR).
  
  
  RESULTS
  There were no significant differences in fertilization rates between the two subgroups. A comparison between testicular sperm extraction (TESE) versus ejaculated sperm cycles revealed significantly higher implantation rate (20.7% vs. 5.7%), higher PR (42.5% vs. 15.1%), and higher take home baby rate (27.5% vs. 9.4%). A multivariable logistic regression analysis showed three significant predictors for pregnancy, namely the use of testicular sperm (odds ratio [OR] 5.1, 95% confidence interval [95% CI] 1.8-14.8), use of motile sperm (OR 12.9, 95% CI 2.1-79.1), and female age (OR 0.83, 95% CI 0.7-0.9).
  
  
  CONCLUSIONS
  Testicular sperm extraction is justified in patients with cryptozoospermia who fail to conceive by ICSI using ejaculated spermatozoa, as it offers higher PR.
authors.affiliation: IVF and Infertility Unit, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. idorit@netvision.net.il
authors.forename: Ido
authors.initials: I
authors.lastname: Ben-Ami
authors.forename: Arieh
authors.initials: A
authors.lastname: Raziel
authors.forename: Deborah
authors.initials: D
authors.lastname: Strassburger
authors.forename: Daphna
authors.initials: D
authors.lastname: Komarovsky
authors.forename: Raphael
authors.initials: R
authors.lastname: Ron-El
authors.forename: Shevach
authors.initials: S
authors.lastname: Friedler
mesh_terms: D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D004542:Ejaculation; D010064:Embryo Implantation; D005260:Female; D005298:Fertility; D005306:Fertilization; D006801:Humans; D050498:Live Birth; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D009845:Oligospermia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic; D013081:Sperm Motility; D053625:Sperm Retrieval; D016896:Treatment Outcome