Testicular sperm extraction and intracytoplasmic sperm injection: a simplified method for treatment of obstructive azoospermia

Objective: To assess the effectiveness of a simple method of testicular sperm extraction for the treatment of obstructive azoospermia. Design: Retrospective study. Setting: Teaching tertiary medical center. Patient(s): Seventeen men with obstructive azoospermia. Intervention(s): The patients underwent 19 cycles of intracytoplasmic sperm injection (ICSI) using testicular sperm. In 5 cycles, testicular sperm extraction was performed after failed microepididymal sperm aspiration. In 14 cycles, testicular sperm extraction was performed in the office under local anesthesia from the outset. The outcome was compared with ICSI cycles using ejaculated sperm (95 cycles) and epididymal sperm (12 cycles fresh and 9 cycles frozen-thawed). Main Outcome;Measure(s): Clinical pregnancy and implantation rates. Result(s): There were no differences in the fertilization, cleavage, implantation, or clinical pregnancy rates among ICSI cycles using testicular, epididymal (fresh or frozen-thawed), or ejaculated sperm. Conclusion(s): When used in conjunction with ICSI, testicular sperm extraction from small excisional biopsy is a simple and cost-effective method for the treatment of obstructive azoospermia. (C) 1997 by American Society for Reproductive Medicine.