PREGNANCIES AFTER INTRACYTOPLASMIC INJECTION OF SPERM COLLECTED BY FINE-NEEDLE BIOPSY OF THE TESTIS

Objective: To investigate the use of intracytoplasmic sperm injection with sperm collected by fine needle biopsy of the testis as a treatment for male genital tract obstruction. Design: Sperm isolated from a fine needle biopsy of the testis were used to inseminate oocytes by intracytoplasmic sperm injection. Setting: A hospital-based tertiary referral infertility service. Patients: Case studies of two couples in whom the male partner had a genital tract obstruction. Main Outcome Measures: Fertilization and pregnancy. Results: In the first ease, 9 oocytes fertilized normally out of 13 injected. After the transfer of fresh (one cycle) and frozen (four cycles) embryos, a single intrauterine fetal heart pregnancy was achieved. In the second case, five oocytes fertilized normally from nine oocytes injected; two embryos were transferred fresh and three were frozen. A single fetal heart intrauterine gestation was obtained after the initial transfer of two fresh embryos. Conclusions: A high normal fertilization rate and pregnancies are possible with intracytoplasmic sperm injection using sperm collected directly from the testis. Sperm retrieval by fine needle biopsy offers a viable alternative to microsurgical aspiration and is also suitable for treating patients with intratesticular blockage.