Journal Article

Cumulative delivery rates after ICSI treatment cycles with freshly retrieved testicular sperm: a 7‐year follow‐up study

Kaan Osmanagaoglu, Valerie Vernaeve, Efstratios Kolibianakis, Herman Tournaye, Michel Camus, Andre Van Steirteghem and Paul Devroey

in Human Reproduction

Published on behalf of European Society of Human Reproduction and Embryology

Volume 18, issue 9, pages 1836-1840
Published in print September 2003 | ISSN: 0268-1161
Published online September 2003 | e-ISSN: 1460-2350 | DOI: http://dx.doi.org/10.1093/humrep/deg346
Cumulative delivery rates after ICSI treatment cycles with freshly retrieved testicular sperm: a 7‐year follow‐up study

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BACKGROUND: The purpose of this study was to assess cumulative delivery rates in patients with non‐obstructive or obstructive azoospermia following treatment by testicular sperm extraction (TESE)–ICSI. METHODS: A cohort follow‐up study was conducted. Between January 1994 and December 2000, 364 couples with obstructive azoospermia underwent a total of 609 fresh TESE–ICSI treatment cycles. In addition, 303 fresh TESE–ICSI treatment cycles were performed in 235 couples for non‐obstructive azoospermia. This study included only patients in whom sperm was recovered. In the non‐obstructive group, only patients with maturation arrest, atrophic sclerosis and germ cell aplasia were included. The main outcome measure was a delivery beyond 25 weeks gestation. RESULTS: In patients with obstructive azoospermia, the crude delivery rate after three cycles was 35% while the expected cumulative delivery rate was 48% [95% confidence interval (CI), 41–55]. On the other hand, in patients with non‐obstructive azoospermia, the crude cumulative delivery rate after three treatment cycles was 17% while the expected delivery rate was 31% (95% CI, 15–46). A high dropout rate in couples with both non‐obstructive and obstructive azoospermia was observed (75 and 50% respectively, after the first cycle). CONCLUSION: This study shows that there is a value in performing several TESE–ICSI attempts in patients with obstructive and non‐obstructive azoospermia. The estimates of the non‐obstructive group beginning from the third cycle are less reliable due to fewer patients. However, overall, the obstructive group performed better than the non‐obstructive group.

Keywords: Key words: cumulative pregnancy rates/life‐table/non‐obstructive azoospermia/obstructive azoospermia/TESE‐ICSI

Journal Article.  3152 words.  Illustrated.

Subjects: Reproductive Medicine

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