The use of testicular sperm for intracytoplasmic sperm injection in patients with necrozoospermia

Objective To investigate whether intracytoplasmic sperm injection (ICSI) using testicular spermatozoa from necrozoospermic patients results in acceptable fertilization and transfer rates. Design Retrospective clinical study. Setting Tertiary referral center. Patients Five patients presenting consistently with 100% dead spermatozoa in their ejaculates. Interventions In seven treatment cycles, an open testicular biopsy was performed to increase the chances for retrieving viable spermatozoa which were used for ICSI. Main Outcome Measures Sperm recovery, fertilization, and transfer rates. Results Testicular sperm were recovered in all treatment cycles and fertilization occurred in six of seven cycles. Overall normal fertilization and transfer rates were 67% and 71%, respectively. One live birth was obtained after five ETs. Conclusion We recommend testicular sperm recovery for ICSI in patients who invariably or occasionally present with absolute necrozoospermia.