Fertilization, embryonic development and pregnancy losses with intracytoplasmic sperm injection for surgically-retrieved spermatozoa.

Prior to the development of intracytoplasmic sperm injection (ICSI), azoospermic and severely oligozoospermic men had little to no chance of having a biological child. In this study, ICSI outcome in 454 transfers with ejaculated spermatozoa and 59 transfers with surgically retrieved spermatozoa were evaluated. Normal fertilization rate using ejaculated spermatozoa was 75% of 5995 oocytes, and 73% of 751 oocytes for surgically retrieved spermatozoa; with ongoing pregnancy rates of 53% (242/454) and 61% (36/59) respectively. Surgically retrieved spermatozoa significantly (P < 0.05) impacted 1PN oocytes (6.1%, 46/751), severely fragmented embryos (8.8%, 46/550) and incidence of pregnancy loss (11%, 4/36). When using ejaculated spermatozoa, incidence of 1PN oocytes, severely fragmented embryos and pregnancy loss was 2.9% (177/5995), 4.5% (200/4365), 2.4% (6/242) respectively.