Intracytoplasmic sperm injection, fertilization, and embryo transfer after retrieval of spermatozoa by testicular biopsy from an azoospermic male with testicular tubular atrophy

Objective: To achieve fertilization and cleavage by spermatozoa retrieved by testicular biopsy from a male with testicular tubular atrophy. Design: Clinical trial. Setting: Private reproductive institute. Patient: Azoospermic male with demonstrated testicular tubular atrophy and almost complete spermatogenic arrest. Intervention: Open biopsy retrieval of testicular tissue and sperm followed by intracytoplasmic sperm injection. Main Outcome Measures: Fertilization and cleavage. Results: One four- to six-cell embryo was formed after intracytoplasmic sperm injection of five eggs with extruded polar bodies by retrieved sperm. Conclusion: Intracytoplasmic sperm injection after testicular sperm aspiration may be attempted in cases with severely decreased spermatogenesis and result in fertilization, cleavage, and embryo transfer.