Intracytoplasmic sperm injection in obstructive and non-obstructive azoospermia

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility

Background:

• Azoospermia, the absence of sperm in ejaculate, affects male fertility.
• Obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) are distinct conditions.
• Congenital absence of the vas deferens (CAVD) is a specific cause of OA.

Purpose of the Study:

• To compare intracytoplasmic sperm injection (ICSI) outcomes across different azoospermia classifications.
• To evaluate ICSI success rates using epididymal versus testicular spermatozoa in obstructive azoospermia.
• To assess ICSI efficacy in acquired obstructive azoospermia versus congenital obstructive azoospermia (CAVD).

Main Methods:

• Retrospective analysis of 241 ICSI cycles in 222 patients.
• Patients categorized into obstructive azoospermia (n=119) and non-obstructive azoospermia (n=103) groups.
• Subgroup analysis for sperm source (epididymal vs. testicular) and obstructive azoospermia type (acquired vs. CAVD).

Main Results:

• Fertilization and pregnancy rates per cycle: epididymal sperm (59.5%, 27.3%), testicular sperm (54.4%, 31.9%) in OA.
• Fertilization and pregnancy rates per cycle in NOA: 39%, 11.3%.
• Acquired OA showed higher rates (56.6%, 37%) than CAVD (55.2%, 20.4%).

Conclusions:

• ICSI success is influenced by the type and cause of azoospermia.
• Acquired obstructive azoospermia demonstrates superior ICSI outcomes compared to CAVD and non-obstructive azoospermia.
• Sperm source (epididymal vs. testicular) shows comparable ICSI results in obstructive azoospermia.