Factors affecting pregnancy and abortion rates following intra cytoplasmic sperm injection in the obstructive and non-obstructive azoospermic men

Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of azoospermic men. The aim of this study was to evaluate the factors interfering in the success of ICSI, including sperm collection method, testicular histology, age and hormonal assay of the couple, the number of retrieved oocytes, and the number of transferred embryos. In this retrospective cohort study, 246 azoospemic men (52 with obstructive azoosprmia (OA) and 194 with non obstructive azoospermia (NOA)) who were underwent sperm retrieval with PESA or TESE and ICSI protocol were studied. By long protocol of ovarian stimulation, oocytes were retrieved 36h after hCG administration. After 48h, cleaved embryos were replaced in the uterine cavity. Clinical pregnancy rates (21.1% in OA versus 10.8% in NOA) was significantly correlated with sperm origin (P<0.05). Female partner’s age and serum FSH significantly influenced pregnancy rates in both groups (p<0.001) and also pregnancy rates was significantly influenced by number of retrieved oocytes and transferred embryos in NOA groups (P<0.05). ICSI can make a chance for fertility in azoospermic men. Higher success rates in OA patients can be related to better quality of sperm. The value of male hormonal assay and testicular biopsy was not remarkable.