Testicular sperm aspiration (TESA) in 327 ICSI cycles.

Objective-To evaluate the efficiency of testicular sperm recovery by testicular sperm aspiration (TESA) in an IVF program. Design-Retrospective Data Analysis. Setting-The Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. Patient(s)-Couples undergoing TESA/ICSI for obstructive or nonobstructive azoospermia. Intervention(s)-TESA/ICSI. Main outcome measure(s)-Efficiency of testicular sperm recovery, fertilization rate, implantation rate and clinical pregnancy rate. Result(s)-Between March 1, 1997 and March 31, 2005, 327 cycles of TESA/ICSI were performed in couples in which the male had obstructive or nonobstructive azoospermia. The efficiency of testicular sperm recovery was 99.4% and 99.3%, fertilization rate 57.1% and 49.1%, implantation rate 5.7% and 6.2%, and the clinical pregnancy rate 12.9% and 15.4% in men with obstructive and nonobstructive infertility, respectively. Conclusion(s)-The efficiency of TESA is very high in both obstructive and nonobstructive azoospermia. Because TESA is less invasive than TESE, it should be considered a valuable alternative to TESE in IVF programs, especially in setting where resources are limited.