Sperm retrieval for assisted fertilization in azoospermia

Couples where the man presents azoospermia, could not be helped to become genetic parents by assisted reproduction in Norway until recently. A temporary permission to perform techniques that can help these couples was granted with a change in the Norwegian laws on biotechnology in 2004. Our experience with intra cytoplasmic sperm injection (ICSI) using sperm retrieved by testicular sperm extraction (TESE) is presented. 94 couples (man with azoospermia) who had undergone examination and work-up at Fertilitetsklinikken Sør in the period 2004-06, were followed. Of these couples, 60 had been treated with TESE-ICSI. TESE is performed in an out-patient setting under local anaesthesia as an open testicular biopsy. By a special technique, sperm cells are retrieved from the biopsy and then used for fertilizing oocytes from the partner. 100 ovarian stimulation-cycles for TESE-CSI have been performed at our clinic. This has led to 82 Embryo Transfers (ET) using fresh embryos and 40 ET using frozen/thawed embryos. 39 clinical pregnancies have been achieved. Thus, there is a 39% chance for pregnancy per started stimulation-cycle. These results are comparable to those from ICSI using ejaculated sperm cells. The TESE-ICSI treatment seems to be a good method to help couples become genetic parents when the man presents azoospermia.