Comparison of Intracytoplasmic Sperm Injection Outcomes between Oligozoospermic, Obstructive Azoospermic and Non-Obstructive Azoospermic Patients

Background: To determine the differences in sperm quality and results of intracytoplasmicsperm injection (ICSI) cycles between three groups of male factor infertilecouples: oligozoospermic, obstructive azoospermic and non-obstructive azoospermic.Materials and Methods: In this prospective cohort study, 628 male factor infertile coupleswho underwent ICSI cycles from April 2004 to March 2006 were enrolled. Three hundredfourteen oligozoospermic patients (group I), 180 obstructive azoospermic patients (groupII) and 134 non-obstructive azoospermic patients (group III) were included. Fertilization,cleavage, implantation and clinical pregnancy, early abortion rates were assessed. Chisquareand analysis of variances with Post Hoc (Tukey test) were used for data analysis.Results: Fertilization rates were significantly different in the three groups (group I:66.6%; group II: 51.8%; group III: 47.7%; p=0.004). There were differences in theimplantation rates (I: 19.5%; II: 17.6%; III: 6.4%; p=0.001). The cleavage rates werefound to be 55.1% (group I), 47.5% (group II), 45.5%(group III), respectively. The clinicalpregnancy rate was the lowest in the third group (I: 37.6%; II: 28.9%; III: 13.4%;p=0.001). There was no significant difference in early abortion rates between the threegroups: (I: 10.7%; II: 9.8%; III: 8%; p=0.776).Conclusion: It can be concluded that patients with oligozoospermia may benefit the mostfrom ICSI treatment. ICSI cycles which use spermatozoa from non-obstructive azoospermicpatients have a lower chance for successful outcome. The results of this studysuggest, in cases of failure to achieve pregnancy after 1 or 2 cycles in non-obstructiveazoospermic patients, embryo donation would be a better alternative.