Endocrine Abstracts

Introduction: We evaluated the efficiency of TESA–ICSI method in infertile men with obstructive azoospermia. Testicular spermatozoa are obtained by fine-needle aspiration of testis (23 G) and than injected into cytoplasm of the oocyte.

Methods: In the study, there were 173 married couples with 253 attempts of artificial fertilization (1.45 attempts per couple). Average age of women were 31 years and of men 36 years. Obstructive azoospermia was detected with clinical examination, semen analyses, hormone tests, fine-needle aspiration of testes and genetic tests (CFTR-DNA analysis). Stimulation of foliculogenesis was performed in accordance with the short/long protocol (GnRH analogues-rec. FSH-HCG) with usual oocyte aspiration time. Fertilization is performed by one single testicular spermatozoon which is injected into the oocyte’s cytoplasm (ISCI).

Results: The laboratory results are expressed as mean value (and range). Volume of the semen 2.6 ml (0.2–5.1); acid phosphatase 712 U/I (125–1770); fructosis 12.5 mmol/l (0.0–33.6); LDH-C4 unmeasurable; LH, FSH, testosterone, oestradiol and prolactine were normal; sperm/sertoli index: left 0.27 (0.09–1.40), right 0.29 (0.11–1.51). CFTR-DNA analysis found 9 heterozygotic mutation carriers. There were no female mutation carriers enabling fertilizations. On average 8.8 (range 2–21) aspirated oocytes, 5.3 (range 1–8) embryos were obtained. There were 88 pregnancies.

Conclusion: TESA–ICSI seems to be very safe, simple and successful technique of assisted reproduction (34.5% per embryo transfer and cumulative 50.6% of pregnancies).