Korean J Fertil Steril.  2003 Sep;30(3):207-216.

Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia

• Park CW
• Koong MK
• Yang KM
• Kim JY
• Yoo KJ
• Seo JT
• Song SJ
• Park YS
• Kang IS
• Jun JH

Abstract

OBJECTIVE
To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia.
METHODS
From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI-fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR)- were statistically analysed in obstructive versus non-obstructive azoospermia.
RESULTS
There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia.
CONCLUSION
Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

Keyword

Azoospermia; TESE; Fertilization rate; Clinical pregnancy rate; Clinical abortion rate

MeSH Terms

Abnormal Karyotype
Abortion, Induced
Azoospermia*
Cardiopulmonary Resuscitation
Embryo Transfer
Embryonic Structures
Female
Fertilization in Vitro*
Humans
Karyotype
Oocytes
Pregnancy
Pregnancy Outcome*
Pregnancy Rate
Pregnancy*
Sperm Injections, Intracytoplasmic*
Sperm Retrieval
Spermatozoa