RESUMEN
Background: With introduction of intracytoplasmic sperm injection with testicular sperm extraction or precutaneouse epididymal sperm aspiration, effective treatment was provided for azoospermic men. The aim of present study was to compare clinical outcome following intracytoplasmic sperm injection using extracted testicular/epididymal sperm or ejaculated severe oligoasthenoteratozoospermic sperm
Methods: After retrospective evaluation of more than four hundred medical records of patients undergoing intracytoplasmic sperm injection Mehr medical institute [between 2011-2012], 45 cycles with severe eligoasthenoteratozoospermia and 34 cycles with azoospermia were included. Patients were treated with gonadotropin releasing hormone agonist. The clinical characteristics and intracytoplasmic sperm injection outcome such as the rate of fertilization, implantation and clinical pregnancy were compared between the two groups. Results were presented as mean +/- standard deviation and number [percent]
Differences between variables were analyzed using student's t test and the chi-square test was used to examine differences between categorical variables. P value less than 0.05 were considered as statistically significant
Results: Mean of female age [29+/-4.9 vs. 30.2+/-5.8], body mass index [26.9+/-5.3 vs. 26.9+/-3.8], estradiol level on human chorionic gonadotropin administration day [1375.6+/-843.9 vs. 1181.8+/-673.1], total number of retrieved oocytes [9.7+/-5.3 vs. 9.2+/-5.9] and metaphase II oocytes [7.7+/-5.1 vs. 7.5+/-5.4] were similar between the two groups. Of 436 and 313 retrieved oocytes, respectively 232 and 163 oocytes were fertilized in oligoasthenoteratozoospermic and azoospermic groups [53.2% vs. 52.1%, P=0.214]. There were not statistical differences between groups in number of transferred top quality embryos [1.5+/-1.2 vs. 1+/-1.2, P=0.09], implantation rate [22.7% vs. 16.9%, P=0.238] and clinical pregnancy rate [21 [47.7%] vs. 11 [35.4%], P=0.199]
Conclusion: Intracytoplasmic sperm injection with precutaneouse epididymal sperm aspiration and testicular sperm extraction are effective methods to treat azoospermic men and its clinical outcome were comparable to ejaculated sever oligoasthenoteratozoospermic cycles. It can be concluded that the influence of sperm quality and origin on intracytoplasmic sperm injection outcome are the same