[Azoospermia : In vitro fertilization results, using testicular biopsy and cryopreserved spermatozoa]

Abstract

Testicular sperm extraction (TESE) by open testicular biopsy, has become, since the introduction of the ICSI in 1992, the corner stone in treatment for azoospermia. This study reports the outcome of patients with open testicular biopsy for ICSI procedure indicated by azoospermia. 16 patients with azoospermia (12 obstructive and 4 non obstructive). The open testicular biopsy was performed prior the controlled ovarian hyperstimulation (COH) protocols of their couples, in two of the 16 patients no sperm were found in the biopsy, and the other 14 patients were admitted to 18 ICSI cycles, and the testicular samples were cryopreserved until oocyte capture. The controlled ovarian hyperstimulation (COH) was individualized in each case in accordance to the characteristics of each patient: 12 patients were used the long luteal phase GnRH agonist protocol, ultrashort protocol (Flare up) in one patient, GnRH antagonist in four, and the last one with endometrial preparation for cryopreserved embryo transfer. The mean of oocytes recovered was 11.71 +/- 7.24 oocytes per patient with a recovery rate of 72.64%. The fertilization rate was 49.35 +/- 29.24 and were transfered an average of 3 embryos per patient with a range between 1 and 5 embryos. In 18 cycles, 7 pregnancies occurred, four singles, one twin, one triple and one biochemical pregnancy. In conclusion the testicular sperm extraction (TESE) by open testicular biopsy is a good option for patients with azoospermia usually it achieves an adequate sample of testicular tissue with high possibilities of sperms recovery, in our study we obtained appropriate sperms in fourteen of sixteen patients for the ICSI procedure with good fertilization and pregnancy rates.