Fertility outcome after Intracytoplasmic Sperm Injection with surgically retrieved sperm

J Gynecol Obstet Hum Reprod. 2021 Jun;50(6):101940. doi: 10.1016/j.jogoh.2020.101940. Epub 2020 Oct 9.


Background: Surgically retrieved sperm samples and Intra Cytoplasmic Sperm Injection are indicated when we face severe sperm abnormalities such as azoospermia. The objective of this study was to assess the rates of clinical pregnancies and live births with sperm from testicular biopsies.

Design: This was a retrospective descriptive study of all Intra Cytoplasmic Sperm Injection (ICSI) cycles performed with surgically retrieved sperm at the Nîmes University Hospital from January 1st, 2015 to December 31st, 2018. The main outcome was the clinical pregnancy rate. The secondary outcomes were the fertilization rate, the implantation rate and the live birth rate.

Results: In all, 99 couples were treated at our center during this period and 164 ICSI cycles using surgically-collected sperm were performed. The men were 34.7 ± 7.4 years old on average at the time of undergoing testicular biopsy and the women were 32.15 ± 5.07 years at the time of ICSI. Out of 127 fresh embryo transfers, we observed 47 clinical pregnancies (37 %) and 45 live births (35.4 %). The average fertilization rate was 45 % and the implantation rate was 23.7 %. Among these infertile couples, 53 % obtained at least one clinical pregnancy and 42 % at least one live birth.

Conclusion: Testicular sperm extraction combined with ICSI is indicated in cases of male infertility linked with azoospermia or severe semen alteration. This technique offers couples a marvelous opportunity to have children with their own gametes.

Keywords: Azoospermia; Clinical pregnancy; ICSI; Live birth; Male infertility; Testicular sperm extraction.

MeSH terms

  • Adult
  • Biopsy
  • Female
  • Humans
  • Live Birth*
  • Male
  • Pregnancy
  • Pregnancy Rate*
  • Retrospective Studies
  • Sperm Injections, Intracytoplasmic*
  • Sperm Retrieval*
  • Testis / pathology