TESTICULAR VERSUS EPIDIDYMAL SPERMATOZOA IN INTRACYTOPLASMIC SPERM INJECTION TREATMENT CYCLES
Abstract
Background: Normal fertilization and ongoing pregnancy can be achieved using intracytoplasmicsperm injection (ICSI), even with severely immature spermatozoa. However, the published literature
documents conflicting results as to the outcome of ICSI. Methods: Surgical extraction of spermatozoa
in 111 ICSI treatment cycles performed over five years at the Assisted Conception Unit (ACU),
University College Hospital (UCH), was retrospectively evaluated to compare the outcome of ICSI
treatment using either testicular or epididymal spermatozoa. Results: A higher normal fertilization rate
and lower abnormal fertilization rate was observed in the epididymal spermatozoa group than in the
testicular spermatozoa group. Embryo development on day 3 after fertilization and implantation was
significantly better in the epididymal spermatozoa group. Clinical and ongoing pregnancy rates were
higher and the spontaneous miscarriage rate lower in the epididymal spermatozoa group, but only the
clinical pregnancy rate reached statistical significance. Conclusions: The origin of surgically extracted
spermatozoa has an effect on the success of assisted reproduction using ICSI, and the immaturity of
testicular spermatozoa may affect fertilization, embryo development, implantation and pregnancy.
Keywords: IVF, male factor, azoospermia, surgical extraction of spermatozoa, outcome
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