High pregnancy rate achieved in cases of azoospermia using the testicular sperm extraction (TESE) combining with the intracytoplasmic sperm injection (ICSI) technique

Abstract

Objective Treatment of azoospermia with the intracytoplasmic sperm injection technique using the testicular sperm extract.

Method From January 1997 to July 1998, 21 infertile couples suffered from azoospermia were treated by using the TESE combining with the ICSI technique. The mean age of the female partner was 33.9 years (range 28-42). Ovarian stimulation was carried out using desensitizing protocol of GnRH analogue (Suprefact) in association with the hMG (Metrodin) injection. The oocyte pick up was due when the largest follicle reach 18 mm. in size. Testicular biopsy was performed on the same day as the oocyte pick up as the out-patient under local anesthesia.

Results From the 27 treatment cycles, 436 oocytes were retrieved, of which 322 (73.9%) were in Metaphase II. All the Metaphase II oocytes had undergone for the ICSI with yielded the fertilization rate of 66.2%. Out of the 27 transfer cycles, 12 achieved pregnancy (44.45% preg nancy rate); of which, 8 were singleton, 2 were twin gestation, and 2 were aborted. All the infants born were completely normal. In conclusion, this study has demonstrated that some cases of the azoospermic males are, in fact, potentially fertile. With the use of the TESE com bining with the ICSI technique, many of them can achieve high rate of fertilization and preg nancy comparable to those who are normally fertile.