Comparison of Intracytoplasmic Sperm Injection Outcomes Between Oligozoospermic, Obstructive Azoospermic and Non-Obstructive Azoospermic Patients

Overview

Journal Int J Fertil Steril

Specialty Reproductive Medicine

Date 2014 Dec 16

PMID 25505506

Citations 3

Authors

Ensieh Shahrokh Tehraninejad Tehraninejad

Elham Pourmatroud

Mohammad Ali Sadighi Gilani

Mahdi Rakebi

Zahra Azimi Neko

Arezoo Arabipoor

Affiliations

Soon will be listed here.

Abstract

Background: To determine the differences in sperm quality and results of intracytoplasmic sperm injection (ICSI) cycles between three groups of male factor infertile couples: oligozoospermic, obstructive azoospermic and non-obstructive azoospermic.

Materials And Methods: In this prospective cohort study, 628 male factor infertile couples who underwent ICSI cycles from April 2004 to March 2006 were enrolled. Three hundred fourteen oligozoospermic patients (group I), 180 obstructive azoospermic patients (group II) and 134 non-obstructive azoospermic patients (group III) were included. Fertilization, cleavage, implantation and clinical pregnancy, early abortion rates were assessed. Chisquare and analysis of variances with Post Hoc (Tukey test) were used for data analysis.

Results: Fertilization rates were significantly different in the three groups (group I: 66.6%; group II: 51.8%; group III: 47.7%; p=0.004). There were differences in the implantation rates (I: 19.5%; II: 17.6%; III: 6.4%; p=0.001). The cleavage rates were found to be 55.1% (group I), 47.5% (group II), 45.5%(group III), respectively. The clinical pregnancy rate was the lowest in the third group (I: 37.6%; II: 28.9%; III: 13.4%; p=0.001). There was no significant difference in early abortion rates between the three groups: (I: 10.7%; II: 9.8%; III: 8%; p=0.776).

Conclusion: It can be concluded that patients with oligozoospermia may benefit the most from ICSI treatment. ICSI cycles which use spermatozoa from non-obstructive azoospermic patients have a lower chance for successful outcome. The results of this study suggest, in cases of failure to achieve pregnancy after 1 or 2 cycles in non-obstructive azoospermic patients, embryo donation would be a better alternative.

Citing Articles

Non-Obstructive Azoospermia and Intracytoplasmic Sperm Injection: Unveiling the Chances of Success and Possible Consequences for Offspring.

Majzoub A, Viana M, Achermann A, Ferreira I, Laursen R, Humaidan P J Clin Med. 2024; 13(16).

PMID: 39201081 PMC: 11355217. DOI: 10.3390/jcm13164939.

Novel predictors for livebirth delivery rate in patients with idiopathic non-obstructive azoospermia based on the clinical prediction model.

Zhang L, Wang Y, Zheng X, Lei L, Tang W, Qiao J Front Endocrinol (Lausanne). 2023; 14:1233475.

PMID: 37916146 PMC: 10616858. DOI: 10.3389/fendo.2023.1233475.

Potential of testicular sperm to support embryonic development to the blastocyst stage is comparable to that of ejaculated sperm.

Lee S, Park C, Cheon Y, Lim C J Assist Reprod Genet. 2018; 35(6):1103-1111.

PMID: 29728797 PMC: 6030020. DOI: 10.1007/s10815-018-1191-8.

References

De Croo I, Van der Elst J, Everaert K, De Sutter P, Dhont M . Fertilization, pregnancy and embryo implantation rates after ICSI in cases of obstructive and non-obstructive azoospermia. Hum Reprod. 2000; 15(6):1383-8. DOI: 10.1093/humrep/15.6.1383. View

Palermo G, Cohen J, Rosenwaks Z . Intracytoplasmic sperm injection: a powerful tool to overcome fertilization failure. Fertil Steril. 1996; 65(5):899-908. DOI: 10.1016/s0015-0282(16)58257-0. View

Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J . Sperm chromosome abnormalities in men with severe male factor infertility who are undergoing in vitro fertilization with intracytoplasmic sperm injection. Fertil Steril. 2001; 76(3):479-84. DOI: 10.1016/s0015-0282(01)01957-4. View

Kahraman S, Tasdemir M, Tasdemir I, Vicdan K, Ozgur S, Polat G . Pregnancies achieved with testicular and ejaculated spermatozoa in combination with intracytoplasmic sperm injection in men with totally or initially immotile spermatozoa in the ejaculate. Hum Reprod. 1996; 11(6):1343-6. DOI: 10.1093/oxfordjournals.humrep.a019384. View

Tavmergen Goker E, Sendag F, Levi R, Sendag H, Tavmergen E . Comparison of the ICSI outcome of ejaculated sperm with normal, abnormal parameters and testicular sperm. Eur J Obstet Gynecol Reprod Biol. 2002; 104(2):129-36. DOI: 10.1016/s0301-2115(02)00067-2. View

Tournaye H . Surgical sperm recovery for intracytoplasmic sperm injection: which method is to be preferred?. Hum Reprod. 1999; 14 Suppl 1:71-81. DOI: 10.1093/humrep/14.suppl_1.71. View

Pasqualotto F, Rossi-Ferragut L, Rocha C, Iaconelli Jr A, Borges Jr E . Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm obtained from patients with obstructive and nonobstructive azoospermia. J Urol. 2002; 167(4):1753-6. View

Thonneau P, Marchand S, Tallec A, Ferial M, Ducot B, Lansac J . Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989). Hum Reprod. 1991; 6(6):811-6. DOI: 10.1093/oxfordjournals.humrep.a137433. View

Meniru G, Gorgy A, Batha S, Clarke R, Podsiadly B, Craft I . Studies of percutaneous epididymal sperm aspiration (PESA) and intracytoplasmic sperm injection. Hum Reprod Update. 1998; 4(1):57-71. DOI: 10.1093/humupd/4.1.57. View

10.

Ghanem M, Bakr N, Elgayaar M, El Mongy S, Fathy H, Ibrahim A . Comparison of the outcome of intracytoplasmic sperm injection in obstructive and non-obstructive azoospermia in the first cycle: a report of case series and meta-analysis. Int J Androl. 2005; 28(1):16-21. DOI: 10.1111/j.1365-2605.2005.00491.x. View

11.

Bukulmez O, Yucel A, Yarali H, Bildirici I, Gurgan T . The origin of spermatozoa does not affect intracytoplasmic sperm injection outcome. Eur J Obstet Gynecol Reprod Biol. 2001; 94(2):250-5. DOI: 10.1016/s0301-2115(00)00347-x. View

12.

Irvine D . Epidemiology and aetiology of male infertility. Hum Reprod. 1998; 13 Suppl 1:33-44. DOI: 10.1093/humrep/13.suppl_1.33. View

13.

Vernaeve V, Tournaye H, Osmanagaoglu K, Verheyen G, Van Steirteghem A, Devroey P . Intracytoplasmic sperm injection with testicular spermatozoa is less successful in men with nonobstructive azoospermia than in men with obstructive azoospermia. Fertil Steril. 2003; 79(3):529-33. DOI: 10.1016/s0015-0282(02)04809-4. View

14.

Nicopoullos J, Gilling-Smith C, Almeida P, Norman-Taylor J, Grace I, Ramsay J . Use of surgical sperm retrieval in azoospermic men: a meta-analysis. Fertil Steril. 2004; 82(3):691-701. DOI: 10.1016/j.fertnstert.2004.02.116. View

15.

Hung A, King P, Schlegel P . Uniform testicular maturation arrest: a unique subset of men with nonobstructive azoospermia. J Urol. 2007; 178(2):608-12. DOI: 10.1016/j.juro.2007.03.125. View

16.

Pinheiro R, Lambert J, Benard F, Mauffette F, Miron P . Effectiveness of in vitro fertilization with intracytoplasmic sperm injection for severe male infertility. CMAJ. 2000; 161(11):1397-401. PMC: 1230827. View

17.

Aboulghar M, Mansour R, Serour G, Fahmy I, Kamal A, Tawab N . Fertilization and pregnancy rates after intracytoplasmic sperm injection using ejaculate semen and surgically retrieved sperm. Fertil Steril. 1997; 68(1):108-11. DOI: 10.1016/s0015-0282(97)81484-7. View

18.

Friedler S, Raziel A, Strassburger D, Schachter M, Soffer Y, Ron-El R . Factors influencing the outcome of ICSI in patients with obstructive and non-obstructive azoospermia: a comparative study. Hum Reprod. 2002; 17(12):3114-21. DOI: 10.1093/humrep/17.12.3114. View

19.

Naru T, Sulaiman M, Kidwai A, Ather M, Waqar S, Virk S . Intracytoplasmic sperm injection outcome using ejaculated sperm and retrieved sperm in azoospermic men. Urol J. 2008; 5(2):106-10. View

20.

Ghazzawi I, Sarraf M, Taher M, Khalifa F . Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection. Hum Reprod. 1998; 13(2):348-52. DOI: 10.1093/humrep/13.2.348. View