Fresh motile testicular sperm retrieved from nonobstructive azoospermic patients has the same potential to achieve fertilization and pregnancy via ICSI as sperm retrieved from obstructive azoospermic patients.

OBJECTIVE: To compare the fertilization and pregnancy rates using fresh testicular sperm between nonobstructive azoospermic (NOA) patients and obstructive azoospermic (OA) patients.

DESIGN: We evaluated sperm quality of testicular sperm retrieved by microdissection testicular sperm extraction (MD-TESE) in NOA patients and compared the fertilization rate and pregnancy rate via intracytoplasmic sperm injection (ICSI) between NOA and OA patients.

SETTING: Private hospital-based infertility research laboratory.

PATIENT(S): A total of 58 couples in which the husband was diagnosed with azoospermia.

INTERVENTION(S): Analytic examination of the outcomes and description of the NOA cases achieving pregnancies; oocyte retrieval and testicular sperm retrieval were performed simultaneously.

MAIN OUTCOME MEASURE(S): Comparison of fertilization rate and pregnancy rate at the first ICSI attempt.

RESULT(S): Testicular sperm were retrieved from 17 of 40 NOA patients and 18 of 18 OA patients. Motile sperm were successfully retrieved from 16 of the 17 NOA patients. There was no significant difference in fertilization rate and pregnancy rate between OA and NOA cases. Of the 17 NOA patients, nine pregnancies were achieved using fresh motile testicular sperm.

CONCLUSION(S): Fresh motile testicular sperm retrieved from NOA patients may have the same potential to achieve fertilization and pregnancy as sperm retrieved from OA patients. The MD-TESE technique might contribute to the high retrieval rate of fresh motile testicular sperm even in NOA patients.