Evaluation of prognostic factors for the success of testicular sperm extraction (TESE) and subsequent ICSI procedures: Retrospective analysis of 311 testicular biopsies and 327 ICSI cycles

With the invention of testicular sperm extraction (TESE) even patients with azoospermia had a chance to induce a pregnancy. Both surgical TESE interventions and intracytoplasmatic sperm injection (ICSI) are linked to risks. Therefore we aimed to identify prognostic factors for the success of a testicular sperm extraction and an ICSI treatment. Retrospectively all TESEs performed at the University hospital in Lubeck from 02/1996 to 05/2002 and all ICSI cycles with those sperms were analysed. 286 men underwent 311 TESE procedures. In 73.6% of cases spermatozoa were found. The underlying cause of azoospermia correlated with the presence of spermatids/spermatozoa in the testicular biopsy (p < 0.001). The patient's age, testicular volume and the FSH level were of no prognostic value. 131 couples were subsequently treated in 252 ICSI cycles resulting in a pregnancy rate of 20.3% per embryo transfer and 19.1% per cycle. The number of oocytes retrieved was the only factor that correlated with the pregnancy rate. In conclusion, TESE is a very successful intervention. However, based on clinical parameters it cannot be predicted which patients benefit the most from this procedure.