Factors influencing the outcome of ICSI in patients with obstructive and non-obstructive azoospermia: a comparative study.
Hum Reprod
; 17(12): 3114-21, 2002 Dec.
Article
en En
| MEDLINE
| ID: mdl-12456610
ABSTRACT
BACKGROUND:
Factors influencing success of sperm retrieval in azoospermic patients and outcome of ICSI were evaluated. METHODS ANDRESULTS:
Uni- and multifactorial analysis were performed using logistic and stepwise analysis, following surgical sperm retrieval by percutaneous epididymal sperm aspiration (55 cycles) or testicular sperm extraction (142 cycles) in 52 and 123 patients with obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) respectively. ICSI cycles using fresh or cryopreserved-thawed sperm were included. Sperm were retrieved to allow ICSI in 100 and 41% of OA and NOA patients, with no significant correlation with patients' age or FSH level. Occurrence of pregnancy was significantly correlated with female age (90th quantile 38 years), number of oocytes retrieved (10th quantile five oocytes) and number of oocytes injected (10th quantile four oocytes). Sperm origin (epididymal versus testicular), status (fresh or thawed), male partner's age, and serum FSH had no significant effect upon implantation rate, pregnancy rate per embryo transfer or spontaneous miscarriage rate.CONCLUSIONS:
In OA patients ICSI should be planned in conjunction with surgical sperm retrieval. In contrast, the lack of efficient non-invasive parameters to predict sperm retrieval in NOA suggests that elective surgical sperm retrieval may be offered to these patients prior to ovarian stimulation of their partners, especially when donor back-up is not an alternative. Female factors such as age and ovarian reserve have significant impact upon clinical success rates.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Oligospermia
/
Resultado del Tratamiento
/
Inyecciones de Esperma Intracitoplasmáticas
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Pregnancy
Idioma:
En
Revista:
Hum Reprod
Asunto de la revista:
MEDICINA REPRODUTIVA
Año:
2002
Tipo del documento:
Article
País de afiliación:
Israel