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Pregnancy in an azoospermic patient with markedly elevated serum follicle-stimulating hormone levels
M Gil-Salom1, J Remohí, Y Mínguez
1Instituto Valenciano de Infertilidad, Valencia, Spain.
Objective:
To assess the possibility of achieving a pregnancy in an azoospermic patient with markedly elevated serum FSH level.
Design:
A case report.
Setting:
In vitro fertilization program at the Instituto Valenciano de Infertilidad.
Patient:
An azoospermic patient with small testes and serum FSH level (38.7 mIU/mL) higher than three times normal. Testicular biopsy revealed Sertoli cell-only syndrome with focal spermatogenesis.
Interventions:
Intracytoplasmic microinjection of testicular tissue-extracted spermatozoa.
Main Outcome Measurements:
Fertilization rate, cleavage rate, clinical pregnancy.
Results:
Eight of 11 (73%) intact oocytes showed two pronuclei. All of them cleaved normally. Four embryos were replaced into the uterine cavity and the other four were cryopreserved. A twin clinical pregnancy was achieved.
Conclusion:
Spermatozoa may be present in testicular biopsy specimens of azoospermic patients with severe spermatogenic failure despite markedly elevated serum FSH level. These patients can be fertile after intracytoplasmic testicular sperm microinjection.