Outcome of cycles of oocyte in vitro maturation requiring testicular sperm extraction for nonobstructive azoospermia

Abstract

Objective: To assess the applicability of oocyte IVM in case of nonobstructive azoospermia (NOA).

Design: Case series.

Setting: Private IVF unit.

Patient(s): All male partners were affected by NOA. Twenty-one women (20 normo-ovulatory and 1 with polycystic ovary) underwent 27 IVM treatments. The outcome of controlled ovarian stimulation (COS) cycles in normo-ovulatory women whose partners were affected by NOA was assessed for comparison.

Intervention(s): Spermatozoa from testicular sperm extraction (TESE) samples were retrieved and cryopreserved before treatment.

Main outcome measure(s): Rates of fertilization, pregnancy per cycle and transfer, and implantation.

Result(s): Twenty-seven IVM-TESE cycles were carried out in 21 women. Fertilization rate was 64.4%. In compliance with national legislation, no more than three oocytes were inseminated in each cycle and all developing embryos were transferred. Six single clinical pregnancies were ascertained (22.2% and 27.3% pregnancy rates per cycle and per transfer, respectively). One pregnancy ended in abortion. The others developed to term and gave rise to five healthy babies. Sixty couples underwent standard COS-TESE treatment. Rates of fertilization, clinical pregnancy per cycle, implantation, and abortion were 64.6%, 20.0%, 11.3%, and 16.7%, respectively. Eleven babies were born from ten pregnancies.

Conclusion(s): Oocyte IVM may represent an option in NOA cases.