The Difference in the Outcomes between Surgically Retrieved and Ejaculated Spermatozoa for Intracytoplasmic Sperm Injection Cycles in Sulaimanyah Province
Background: Intracytoplasmic sperm injection (ICSI) is introduced as a treatment modality for severe male factors infertility. It is an effective form of infertility treatment. Progress in the micromanipulation, now is bringing a new way in the treatment of severe male factor infertility to achieve acceptable rates of fertilization and pregnancy success. Objective: To evaluate the difference between ejaculated and surgically retrieved sperm on intra cytoplasmic sperm injection (ICSI) outcomes. Design: A Correlative study. Setting: Dwarozh- IVF center. Patients and Methods: One hundred twenty patients have been taken in Dwarozh and International infertility centers in Sulaimani, for male infertility indications with normoovulatory female partners of ages less than 38 years, from 1st of September 2010 to 1st of September 2013. We divided patients into two groups: patients with normal ejaculation;group one (G1), and patients with surgically retrieved spermatozoa (normal sperms); group two (G2), all underwent Intracytoplasmic Sperm Injection (ICSI) cycles. Main Outcome Measures: Fertilization, cleavage, biochemical and clinical pregnancy rates. Results: The fertilization rate has been found 72.6% in G1, while in G2 it is 60.4% and a significant statistical difference was observed in fertilization rates between the two groups with a P value of less than 0.01. Also it has been found that in G1, 90.2% of oocytes were cleaved, while in G2, 89% of oocytes were cleaved, no significant statistical difference was observed in cleavage rates between the two groups, with a P value of more than 0.05. It has been found that in G1, pregnancy was positive (+ve) biochemically in 65% of the cases, while pregnancy was positive (+ve) clinically in 45% of the cases. In G2 pregnancy were (+ve) biochemically in 28.3%, while pregnancy was (+ve) clinically in 15% of the cases, with significant statistical differences in both biochemical and clinical pregnancies between the two groups with a P value of less than 0.01. Conclusions: It has been found, with the use of ICSI cycles in the treatment of male factor infertility, there are significant differences in reproductive outcomes between cycles using ejaculated and surgically retrieved sperm. The data show that ICSI is aacceptable treatment option in oligospermic and azoospermic males. Acceptable rates of fertilization, cleavage and pregnancy success can be attainwith ICSI from patients with Azoospemia, reaching levels comparable with those of patients using ejaculated spermatozoa for ICSI.