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Human Reproduction, Vol. 10, No. 10, pp. 2595-2599, 1995
© 1995 European Society of Human Reproduction and Embryology

research-article

Testicular needle biopsy, open biopsy, epididymal aspiration and intracytoplasmic sperm injection in obstructive azoospermia

Hovatta Outi1,3, Moilanen Jarna1, Smitten Karl von2 and Reima Ilkka1

1infertility Clinic of the Family Federation of Finland 24th Department of Surgery, University Central Hospital Helsinki,Finland

Correspondence: 33To whom correspondence should be addressed at: Infertility Clinic of the Family Federation of Finland, Kalevankahi 16B, FIN-00100 Helsinki, Finland

Testicular or epididymal spermatozoa were obtained for in-vitro fertilization and intracytoplasmic sperm injection ICSI) in 27 cycles out of 33 (in six men the azoospermia proved to have testicular causes). Testicular needle biopsy carried out in addition to surgical open biopsy proved to be an effective method to obtain spermatozoa for ICSI from patients with obstructive azoospermia. Thus it might be possible to replace scrotal operations by simple needle biopsies. Embryos resulting from ICSI with testicular spermatozoa were used in 19 transfers that resulted in six pregnancies. One pregnancy resulted from six embryo transfers from ICSI after microsurgical-epididymal sperm aspiration (MESA). The normal fertilization rates with testicular (37.3%) and MESA spermatozoa (53.7%) did not differ significantly from each other, but with testicular spermatozoa the rate was significantly lower than that obtained with ejaculated spermatozoa and ICSI (59.7%) in the matched couples. The abnormal fertilization of oocytes with one pronucleus was significantly higher with testicular spermatozoa than with ejaculated spermatozoa in the control couples.

Key words: intracytoplasmic sperm injection/microsurgical/sperm aspiration/testicular needle biopsy/testicular spermatozoa


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