Comparison of intracytoplasmic sperm injection outcomes between oligozoospermic, obstructive azoospermic and non-obstructive azoospermic patients

To determine the differences in sperm quality and results of intracyto-plasmic sperm injection [ICSI] cycles between three groups of male factor infertile couples: oligozoospermic, obstructive azoospermic and non-obstructive azoospermic. In this prospective cohort study, 628 male factor infertile couples who underwent ICSI cycles from April 2004 to March 2006 were enrolled. Three hundred fourteen oligozoospermic patients [group I], 180 obstructive azoospermic patients [group II] and 134 non-obstructive azoospermic patients [group III] were included. Fertilization, cleavage, implantation and clinical pregnancy, early abortion rates were assessed. Chi-square and analysis of variances with Post Hoc [Tukey test] were used for data analysis. Fertilization rates were significantly different in the three groups [group I: 66.6%; group II: 51.8%; group III: 47.7%; p=0.004]. There were differences in the implantation rates [I: 19.5%; II: 17.6%; III: 6.4%; p=0.001]. The cleavage rates were found to be 55.1% [group I], 47.5% [group II], 45.5% [group III], respectively. The clinical pregnancy rate was the lowest in the third group [I: 37.6%; II: 28.9%; III: 13.4%; p=0.001]. There was no significant difference in early abortion rates between the three groups: [I: 10.7%; II: 9.8%; III: 8%; p=0.776]. It can be concluded that patients with oligozoospermia may benefit the most from ICSI treatment. ICSI cycles which use spermatozoa from non-obstructive azoospermic patients have a lower chance for successful outcome. The results of this study suggest, in cases of failure to achieve pregnancy after 1 or 2 cycles in non-obstructive azoospermic patients, embryo donation would be a better alternative