[Comparison of the efficacy of ICSI using either spermatozoa aspired microsurgically from the epididymis (MESA-ICSI)...

Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection (MESA-ICSI) is a viable alternative to the treatment of couple sterility caused by obstructive azoospermia. Because there are structural differences between epididymal and ejaculated spermatozoa and it is not univocally stated, if this fact influences positively or negatively the results of ICSI, it was decided to compare the efficacies of ICSI using both the kinds of spermatozoa at the same setting.

Retrospective comparative analysis.

The MESA group consisted of 27 couples and the control ICSI group of 154 couples--both matched in age, duration of sterility, health status, stimulation protocols and luteal supplementation. The trial was performed at the same period in one center, keeping the same laboratory and personal conditions in both the groups.

In the MESA group the fertilization rate was 53.9%, the cleavage rate 87.6% and pregnancy rates 37.0% per microinjection and 43.5% per embryotransfer. In the control group the corresponding values were 50.1%, 90.0%, 28.0% and 31.7%. The differences between the groups were insignificant.

It may be concluded, that the structural differences between epididymal and ejaculated spermatozoa do not significantly influence the efficacy of ICSI, however further investigations are still needed.