Journals / Turkish Journal of Urology / 2018 / Cilt: 44 - Sayı: 6
Results of intracytoplasmic sperm injection performed with sperm retrieved by microscopic testicular sperm extraction in azoospermic patients
- Journal
- Turkish Journal of Urology
- Pages
- 462–466
- DOI
- —
Özet
Objective: The absence of any sperm in the ejaculate is called azoospermia and it is detected in 1% ofmales and 10-15% of those with infertility complaints. Azoospermia may be due to obstructive (OA) andnon-obstructive (NOA) causes. Today, healthy pregnancies can be achieved in azoospermic patients by intracytoplasmic sperm injection (ICSI) performed using sperm retrieved from microscopic testicular spermextraction (m-TESE). In this study, we examined the sperm retrieval rates with m-TESE in azoospermicpatients, the results of ICSI in OA and NOA patients with sperm and the underlying testicular pathologiesin patients without sperm.Material and methods: Patients who underwent m-TESE at IVF unit of our hospital between January 2005and April 2017 were retrospectively reviewed. A total of 342 azoospermic patients (117 OA and 225 NOAcases) with regular follow-up were included in the study. In these cases, sperm retrieval and clinical pregnancy rates after ICSI were compared.Results: In the m-TESE procedure, motile sperm was found in all of the OA patients and in 52.4% (118/225)of the NOA patients. Clinical pregnancy rate in the OA group was 29.9% (35/117) and live birth rate was25.6% (30/117). In the NOA group, the clinical pregnancy rate was 27.1% (32/118) and the live birth ratewas 23.7% (27/118). Histopathologic evaluation was made in 107 cases in the NOA group with no testicularsperm, revealing that 59 cases with germ-cell aplasia (sertoli-cell only syndrome), 42 cases with maturationarrest, and 6 cases with hypospermatogenesis. Postoperative hematoma developed in 3 of m-TESE cases andsubsided with conservative treatment.Conclusion: If motile sperm is retrieved with m-TESE application in azoospermic patients, pregnancyresulting in one live birth in about 4 couples who undergo ICSI application can be achieved. In the presenceof motile sperm, live birth rates are similar between OA and NOA case with very low complication rates.