Human Reproduction, Vol 13, 348-352, Copyright © 1998 by Oxford University Press
IM Ghazzawi, MG Sarraf, MR Taher and FA Khalifa
A prospective study was carried out to compare the fertilizing capability
and pregnancy outcome following intracytoplasmic sperm injection (ICSI)
using spermatozoa obtained from ejaculates, or surgically from epididymis
or seminiferous tubules. A total of 77 ICSI cycles (one per patient) was
included. In all, 28 patients had severe oligoasthenoteratozoospermia, 19
patients had obstructive azoospermia and 30 patients had non-obstructive
azoospermia. The main outcome measures were fertilization rate per injected
metaphase II oocyte and the clinical pregnancy rate per embryo transferred
back to the female recipients. In patients with severe
oligoasthenoteratozoospermia, the fertilization and pregnancy rates were 79
and 25 %. In patients with obstructive azoospermia, for whom epididymal
spermatozoa were used, these were 75 and 28%, and in the non-obstructive
group for which testicular spermatozoa were used for injection, they were
69 and 21% respectively. These rates were not significantly different in
the three groups (P = 0.85 and P = 0.14 respectively), suggesting that
spermatozoa from the ejaculates and epididymal or testicular biopsies are
able to fertilize equally by using ICSI. Live birth per embryo transfer was
significantly reduced in patients with non-obstructive azoospermia compared
to the other two groups. The high abortion rate (50%) in the group in which
testicular spermatozoa were used raises doubts about the developmental
competence of such embryos.
ARTICLES
Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection
Assisted Reproductive Unit, Al Amal Hospital, Amman, Jordan.
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