Genetic screening of karyotypes and azoospermic factors for infertile men who are candidates for ICSI.

The overall incidence of chromosomal abnormalities was 8%. There was no single distinctive feature of semen parameters predictive of the existence of a chromosomal anomaly. All of the patients with obstructive azoospermia had normal karyotypes and AZF. Three patients out of 13 (23%) with nonobstructive azoospermia without 47,XXY had AZF deletions, as well as two (5%) of 43 with severe oligozoospermia. Ninety-two couples underwent 112 ICSI cycles for which a pregnancy rate of 58% was achieved. Five patients with abnormal karyotypes underwent 6 cycles of ICSI that resulted in 1 successful pregnancy. Two patients with AZF deletions achieved pregnancies. One ICSI-derived male had the same AZF deletion as his father, and 1 female baby had no risk of AZF deletion. The authors recommend karyotyping, excluding those with obstructive causes, prior to ICSI for genetic counseling.