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Korean Journal of Fertility and Sterility 2003;30(3):207-216.
Published online September 1, 2003.
Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia.
Chan Woo Park, Mi Kyoung Koong, Kwang Moon Yang, Jin Young Kim, Keun Jai Yoo, Ju Tae Seo, Sang Jin Song, Yong Seog Park, Inn Soo Kang, Jin Hyun Jun
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Laboratory of Reproductive Biology and Infertility, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
OBJECTIVE
To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. METHODS: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI-fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR)- were statistically analysed in obstructive versus non-obstructive azoospermia. RESULTS: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. CONCLUSION: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.
Key Words: Azoospermia; TESE; Fertilization rate; Clinical pregnancy rate; Clinical abortion rate


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