title: Azoospermia and testicular biopsy before intra-cytoplasmic sperm injection: Does the type of anesthesia make a difference?
abstract: OBJECTIVE
  Azoospermia is the most common form of male factor infertility, due to which sperms are retrieved for intra-cytoplasmic sperm injection (ICSI) under general or local anesthesia. The aim of the present study was to compare the efficacy of general and local anesthesia in an attempt to extract a sufficient quality of sperm for men with azoospermia, who intend to undergo ICSI.
  
  
  METHODS
  A total number of 50 patients with azoospermia, who were within the age range of 20-40, were randomly scheduled for testicular sperm extraction with either general or local anesthesia before ICSI. The hormonal abnormalities and severe varicocele were evaluated and treated before the testicular sperm extraction. The inclusion criteria obliged the researchers to focus on men with azoospermic, those who were diagnosed by two semen analyses after a 3-day abstinence from coitus according to the modified WHO criteria, and 19< body mass index ≤28. The concentration, motility, and morphology of the spermatozoa of the two groups were also compared.
  
  
  RESULTS
  A total number of 76 men, with a mean age of 35.1 ± 6.0, were selected, 26 were excluded from the study, and the remaining participants were randomly divided into two groups such as general anesthesia and lidocaine group. According to the results, the differences between the values of sperm parameters within various hours after the testicle biopsy were not statistically significant. Also, there was no significant difference between the two groups in terms of sperm motility and sperm morphology during various timing after the processing.
  
  
  CONCLUSIONS
  The present study demonstrated that there was no evidence found for values of sperm parameters between the two groups, undergoing local and general anesthesia, within various hours after the testicular biopsy. Further investigations with more focus on concentration-dependent lidocaine on human sperm parameters need to be carried out.
authors.affiliation: Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Seyed Gholam
authors.initials: SG
authors.lastname: Ali Jorsaraei
authors.affiliation: Department of Surgery, Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Shafi
authors.affiliation: Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Hakimeh
authors.initials: H
authors.lastname: Alereza
authors.affiliation: Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Esmailzadeh
authors.affiliation: Department of Midwifery, Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Mouloud Agajani
authors.initials: MA
authors.lastname: Delavar
authors.affiliation: Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Saee
authors.affiliation: Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Maedeh
authors.initials: M
authors.lastname: Fasihiyan
authors.affiliation: Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Golsorkhtabaramiri
keywords: Anesthesia; assisted reproductive techniques; male infertility; sperm retrieval