Comparison of the Clinical Outcomes of Intracytoplasmic Sperm Injection between Spermatozoa Retrieved From Testicular Biopsy and From Ejaculate in Cryptozoospermia Patients

Abstract Objective To compare the clinical outcomes of intracytoplasmic sperm injection (ICSI) between spermatozoa retrieved from testicular biopsy and from ejaculate in cryptozoospermia patients. Methods The clinical data of 285 cryptozoospermia patients, who underwent ICSI treatment in our center during the period from March 2009 to November 2013, were retrospectively analyzed. Within them, ejaculated sperms were used in 214 cases (group 1) and testicular sperms extracted by testicular sperm aspiration (TESA) or conventional testis dissection sperm extraction (TESE) were used in 71 cases (group 2). Good-quality embryo, fertilization, embryo implantation, pregnancy, and birth rates after ICSI were compared between the two groups. Results Comparing the ejaculated sperm group with the testicular sperm group, fertilization rate was 59.6% and 60.6%; good-quality embryo rate was 36.8% and 46.1%; embryo implantation rate was 30.7% and 52.1%; pregnancy rate was 33.3% and 53.6%; and birth rate was 27.1% and 44.6%, respectively. Conclusion Using testicular sperms can achieve higher rates of embryo implantation, pregnancy, and birth compared with those using ejaculated sperms for ICSI treatment in cryptozoospermia patients.