Outcomes of Intracytoplasmic Sperm Injection in Obstructive and Non-Obstructive Azoospermia

Abstract

background: infertile couples due to male factor reasons present with azoospermia asa cause of their infertility can positively benefit from intracytoplasmic sperminjection (ICSI) for fathering genetics offspring's.Aim of study: to compare the intracytoplasmic sperm injection outcomes in obstructive and non-obstructive azoospermic men.Materials and methods: A retrospective study compromised 42 couples seeking for treatment due to azoospermia as a cause of infertility. 19 men out of 42 had obstructive azoospermia (OA) and the remainder 23 man had non-obstructive azoospermia (NOA). All those males underwent surgical sperm retrieval techniques either testicular sperm extraction (TESE) in all NOA cases and some OA cases or percutaneous epididymal sperm aspiration (PESA) in the rest of OA cases. Sperms retrieved surgically were used either fresh or after cryopreservation for ICSI and the main outcomes; fertilization, cleavage and pregnancy rates and embryo quality were compared statistically. Data were expressed as mean ±SD and number and percent, and groups were compared by compares of two independent means. Dif-ferences were considered significant at p <0.05.Results: the results revealed significant reduction (p <0.05) in the fertilization rate in couples with NOA (38.2%) compare to (59.5%) for OA group, as well as a significant drop in cleavage (80.6% vs 68.9%) and pregnancy (31.57% vs 13.04%) rates was also shown in NOA group. The mean number of embryos (5.88±3.46 vs 3.33±2.54, p <0.017) obtained by ICSI and percent of good quality embryos (55.2% vs 31.37%, p <0.014) were significantly higher in OA group.Conclusion: type of azoospermia has greater effect on the success of ICSI cycles. The immaturity of testicular sperm in NOA can affect fertilization, embryo development and pregnancy rate.