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VOLUME 2 - NUMBER 3 - 2025

Intracytoplasmic injection of testicular sperm: blastulation rate in patients with obstructive azoospermia, non-obstructive azoospermia, and cryptozoospermia

  • Fabiana Cagnazzo, Elena Albani, Stefano Castellano, Edoardo Carnesi, Luisa Arruzzolo, Paolo Emanuele Levi Setti
  • Original Article, 46-48
  • Full text PDF

  • Purpose: The influence of sperm origin on embryo development remains a crucial issue in assisted reproduction. This study evaluates blastocyst development in patients with obstructive azoospermia (OA), non-obstructive azoospermia (NOA), and cryptozoospermia undergoing testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI).

    Methods: A retrospective analysis was performed on 874 TESE-ICSI cycles: 368 OA, 253 NOA, and 253 cryptozoospermia. Data were stratified by female age (<35 and ≥35 years). Oocytes were injected via ICSI and cultured to the blastocyst stage. Embryo development was evaluated using the Istanbul Consensus criteria. ANOVA and Tukey’s tests assessed differences among groups.

    Results: Blastocyst formation rates were significantly higher in OA patients across both age groups. The OA group had a superior oocyte-to-blastocyst conversion ratio and better-quality embryos. The NOA and cryptozoospermic groups showed delayed development and fewer hatching blastocysts. Female age impacted ovarian reserve but did not significantly influence blastulation outcomes within each diagnostic group.

    Conclusions: The study underscores the role of sperm quality, linked to the underlying male diagnosis, in influencing embryonic development. OA cases showed the most favorable outcomes following TESE-ICSI, likely due to preserved spermatogenesis despite obstruction. Conversely, testicular sperm from cryptozoospermic patients were less competent, possibly due to subtle defects not addressed by surgical retrieval. These findings highlight the importance of male factor considerations in ART success and suggest further investigation into optimizing lab protocols for patients with severely compromised spermatogenesis

  • KEY WORDS: ICSI, azoospermia, blastocyst, sperm quality, obstructive azoospermia (OA), non-obstructive azoospermia (NOA).