Korean J Reprod Med.  2008 Dec;35(4):293-301.

Effect of Testicular Histopathology on Pregnancy Outcomes in Non-Obstructive Azoospermia

• Park CW
• Seo JT
• Park YS
• Kim HO
• Yang KM
• Kim JY
• Koong MK
• Kang IS
• Song IO

Abstract

OBJECTIVE
To evaluate outcomes of patients with non-obstructive azoospermia (NOA) undergoing the testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI) with different histopathologic subgroups. METHOD: A total of 122 embryo-transferred TESE/ICSI cycles were compared among NOA subgroups; Germ-cell aplasia (GA, 40 cycles), Maturation arrest (MA, 32 cycles) and severe hypospermatogenesis (S-HS, 50 cycles). Obstructive azoospermia (OA, 667 cycles) patients were served as a control. TESE/ICSI outcomes such as fertilization rate (FR), clinical pregnancy rate (CPR) and live birth rate (LBR) were evaluated.
RESULTS
The 2PN FR of embryo-transferred TESE/ICSI cycle was 58.1% in GA, 42.2% in MA and 48.0% in S-HS, which was significantly lower than that of OA (72.9 %, p<0.001). For ICSI-spermatozoa cycles, there were no significant differences in CPR (22.6%, 29.4% and 26.1%) and LBR (16.1%, 29.4% and 19.6%) among NOA subgroups. The CPR of ICSI-spermatid cycles was 0.0%, 9.1% and 0.0% without a live birth. For ICSI-spermatocyte cycles, no clinical pregnancies occurred in any group.
CONCLUSION
There was no significant difference in the FR of embryo-transferred TESE/ICSI cycles among NOA subgroups. The FR among all NOA subgroups was significantly lower than that of OA. Testicular histopathology in NOA did not affect successful pregnancy if spermatozoa extraction from the testis is successful and embryo transfer is possible.

Keyword

Non-obstructive azoospermia; Germ cell aplasia; Maturation arrest; Hypospermatogenesis

MeSH Terms

Azoospermia
Cardiopulmonary Resuscitation
Embryo Transfer
Female
Fertilization
Humans
Live Birth
Male
Oligospermia
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Sperm Injections, Intracytoplasmic
Spermatozoa
Testis