Comparison of the ICSI Results From Sperm Obtained by m-TESE at Three Different Periods in Patients with Azoospermia: Retrospective Study

Özet

Introduction: The absence of any spermatozoa in the ejaculate is called azoospermia, and it is seen in 1% of males, resulting in 10%–15% of infertility problems. Azoospermia may be due to obstructive (OA) and non-obstructive (NOA) causes. Microscopic testicular sperm extraction (m-TESE) is often applied today to obtain sperm from patients with azoospermia, and healthy pregnancies can be obtained by performing intracytoplasmic sperm injection (ICSI) with the testicular sperm obtained. In this study, we aimed to compare the ICSI cycle results from fresh sperm obtained by m-TESE on the day of oocyte collection or the day before, and frozen m-TESE sperm. Methods: Between January 2008 and April 2017, patients who underwent m-TESE in the In Vitro Fertilization Unit of our hospital were retrospectively analyzed. A total of 342 patients with azoospermia (117 OA and 225 NOA cases) with regular follow-up were included in the study. The first group underwent m-TESE on the same day, the second group underwent m-TESE 24 hours before, and in the third group, the sperm was frozen after m-TESE. Results: A total of 235 patients, 117 patients with OA (%100) and 118 NOA patients (52.4%), had motile spermatozoa. In 150 patients (85 OA, 65 NOA), the sperm were used the same day, and in 51 patients (24 OA, 27 NOA), one day later. Sperm in 34 patients (8 OA, 26 NOA) was frozen for later use. When ICSI results were evaluated in these groups, the number and rates of fertilization in the OA group were 56 (65.8%), 16 (66.6%), and 5 (62.5%); clinical pregnancy numbers and rates were 30 (35.2%), 9 (37.5%), and 3 (37.5%); and the live birth numbers and rates were 26 (30.5%), 7 (29.1%), and 2 (25.0%), respectively. In the NOA group, fertilization numbers and rates were 46 (70.7%), 19 (70.3%), and 18 (69.2%); clinical pregnancy numbers and rates were 24 (36.9%), 10 (37.0%), and 10 (38.4%); and the live birth numbers and rates were 20 (30.7%), 8 (29.6%), and 8 (30.7%), respectively. Discussion and Conclusion: In the IVF-ICSI applications, there was no difference in terms of fertilization, pregnancy, and live birth rates between the use of frozen sperm or m-TESE on the oocyte collection day or 1 day before.