Objective: To review the treatment results of intracytoplasmic injection of epididymal and testicular sperm obtained from 50 azoospermic patients from January 2003 to May 2004.
Methods: Sperm was retrieved by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) was performed. The rates of successful sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated.
Results: In the PESA, TESE and ejaculation groups, the number of M II oocytes suitable for ICSI were 286, 360 and 1569 respectively. The difference of fertilization rates among the three groups was not significant (74.8%, 75.2% vs 77.5%, P>0.05). No difference was seen in the implantation and clinical pregnancy rates of the TESE group from the ejaculation group (29.87% vs 29.54%; 48.15% vs 52.60%, P>0.05). However the implantation and clinical pregnancy rates were higher in the PESA group compared with the TESE and ejaculation groups (50.85% vs 29.87%, 29.54%; 68% vs 48.15%, 52.60%, P<0.05). In the PESA group, 17 clinical pregnancies were achieved including 9 ongoing pregnancies, and 6 live deliveries and 2 miscarriages. While in the TESE group, 13 clinical pregnancies were achieved including 4 ongoing pregnancies, 7 live deliveries and 2 miscarriages.
Conclusion: ICSI with PESA and TESE is an effective method to treat azoospermia.