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Human Reproduction, Vol. 11, No. 4, pp. 769-771, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Delivery following intracytoplasmic injection of mature sperm cells recovered by testicular fine needle aspiration in a case of hypergonadotropic azoospermia due to maturation arrest

Aby Lewin1, David B. Weiss, Shevach Friedler, Inbar Ben-Shachar, Anat Porat-Katz, Dror Meirow, Joseph G. Schenker and Anat Safran

IVF Unit, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical School P.O.Box 12087, Ein-Kerem, Jerusalem, Israel

Correspondence: 1To whom correspondence should be addressed

This is the first reported delivery following intracytoplasmic sperm injection (ICSI) of mature live testicular sperm cells collected in a case of hypergonadotrophic azoospermia with maturation arrest. The 30 year old couple presented with primary infertility of 11 years duration, the man being submitted in childhood to five orchidopexy operations for the treatment of cryptorchism. He had elevated serum follicle stimulating hormone (FSH; 18.8 IU/1), an atrophic left testis and a normal sized right testis, the biopsy of which diagnosed maturation arrest and focal scarring. The couple refused donor insemination for religious reasons and the only option was an attempt at testicular sperm collection. Multiple testicular and epididymal fine needle aspirations were performed, using an aspiration handle loaded with 20 ml syringe and 21–23 gauge butterfly needles. The mature spermatozoa recovered were used to inseminate the oocytes by ICSL Prior to this procedure, the patient‘s wife underwent ovulation induction using a long protocol of mid-Iuteal gonadotrophin-releasing hormone analogue/human menopausal gonadotrophin (GnRHa/HMG). At oocyte retrieval, ten oocytes were recovered. Eight live sperm cells were recovered from the aspirates of the right testis. Following ICSI into four metaphase II and two metaphase I oocytes, one mature oocyte was fertilized, cleaved and was transferred to the uterus 48 h after oocyte retrieval. The patient conceived and delivered a 3300 g boy at term. In conclusion, our results demonstrate that this novel approach should be considered in cases with hypergonadotrophic azoospermia due to testicular failure. Further experience is needed to establish the exact criteria for its use.

Key words: fine needle aspiration/intracytoplasmic sperm injection/maturation arrest/spenn/testis


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