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Hum. Reprod. Advance Access originally published online on February 3, 2006
Human Reproduction 2006 21(6):1521-1524; doi:10.1093/humrep/del001
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Limiting the number of injected oocytes to three impairs ICSI outcomes in patients with nonobstructive azoospermia

E. Greco1, F. Ubaldi1, L. Rienzi1, M. Iacobelli1, S. Ferrero1, G. Minasi1, S. Romano1, C. Litwicka1 and Jan Tesarik2,3

1 Centre for Reproductive Medicine, European Hospital, Rome, Italy and 2 MAR&Gen, Molecular Assisted Reproduction & Genetics, Gracia, Granada, Spain

3 To whom correspondence should be addressed at: MAR&Gen Calle Rey Abu Said, 19 Urb. Alcázer del Genil 18006, Granada, Spain. E-mail: cmendoza{at}ugr.es

BACKGROUND: Since March 2004, only a maximum of three oocytes were allowed to be subjected to ICSI at one time in Italy. A previous study failed to show an impact of this restriction on fresh embryo transfer outcomes. The objective of this study was to compare ICSI outcomes before and after this restriction in patients with nonobstructive azoospermia. METHODS: Patients underwent testicular sperm extraction followed by ICSI. Biological (fertilization rate and the percentage of good-morphology zygotes and embryos) and clinical (clinical pregnancy and implantation rates) outcomes of the last 100 ICSI attempts before the restriction and outcomes of the first 100 ICSI attempts after the restriction were compared. RESULTS: Despite comparable fertilization rates (58.8% versus 59.2%; P > 0.05), there was a significant decrease in the percentage of good-morphology zygotes (41.1% versus 88.4%; P < 0.05) and embryos (36.7% versus 74.0%; P < 0.05) in the cohort of embryos transferred, clinical pregnancy rate (22.7% versus 42.4%; P < 0.05) and cumulative pregnancy rate from fresh and frozen embryo transfers (22.7% versus 53.5%; P < 0.05) after the restriction. CONCLUSION: The oocyte number restriction reduces dramatically the chance of achieving a clinical pregnancy in cases of nonobstructive azoospermia.

Key words: clinical outcomes/ICSI/nonobstructive azoospermia/oocyte number/testicular sperm


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