Assisted Reproductive Technique Outcome in Testicular Sperm Extraction-Intracytoplasmic Sperm Injection Cycles with Poor Female Response A Report on 8 years' Experience

OBJECTIVE: To evaluate the outcome in couples composed of azoospermia and a poor responder female undergoing assisted reproductive techniques (ARTs). STUDY DESIGN: A retrospective study was performed involving 97 men suffering from nonobstructive azoospermia (NOA) whose partners had a poor response to ovarian stimulation. Poor response was defined as retrieval of fewer than 5 oocytes. Main outcome measures were implantation rate (IR), clinical pregnancy rate per embryo transfer (CPR/ET) and early pregnancy loss rate (EPLR). RESULTS: Overall IR, CPR/ET and EPLR were found to be 16%, 23% and 15%, respectively, which were significantly lower than those in NOA men with normoresponder partners except EPLR (25%, 52% and 24%, respectively). When the results were further stratified according to number of oocytes retrieved. and body mass index, no significant difference was observed between the groups. However, when the results were analyzed according to the woman's age, a significantly lower CPR/ET was found in poor responder women aged >= 38 years (11% vs. 33%; p = 0.03). CONCLUSION: Although success of ART is suggested to be high once motil spermatozoa are found in testicular sperm extraction in NOA cases, poor response to ovarian stimulation might be considered as one of the strongest determinants of the outcome. (J Reprod Med 2009;54:691-697)