Outcomes of Intracytosplasmic Sperm Injection Among obstructive Azoospermia Patients in kerbala, Iraq
Background; considering the cost and complications of the Intracytoplasmic sperm injection (ICSI), studying some parameters that may predict its outcome is important. In addition, there is heterogeneity in the success rate among center, thus it would be useful to describe the data of different centers.
Aim of the study: to evaluate the rate of ICSI success among Obstructive azoospermia treated in AL-Kafeel IVF center, Kerbala,Iraq, with some emphasis on female factors that may predict that ICSI outcome.
Study design: A retrospective study
Materials and Methods: Data of all couples who underwent ICSI with fresh sperm retrieval using testicular sperm aspiration (TESA) and reached the stage of embryo transfer during the period from 1st January 2015 to 1st January 2019 were included. Demographic data of couples and hormonal assays results were recorded. Data included such as number of oocyte collected, quality of oocytes, fertilization rate and clinical pregnancy rate. Clinical pregnancy was identified by measuring HCG hormone level in day 12-14 after embryo transfer.
Results and Discussion: The total couple underwent ICSI was 42. The rate of fertilization was 69.55% whereas the clinical pregnancy rate was 33.3% which is similar to pregnancy rates in normospermic individuals. No effect of age of couples on the outcome of ICSI. TSH level in females was significantly higher in females with ICSI positive compared to females with failed ICSI (p=0.047) with average TSH concentration of 3.4 in ICSI successor and 2.038 in failed ICSI. Number of Grade 1 embryos was higher in ICSI successor than in ICSI failed couples. In addition, the levels of LH and AMH were shown to be increased I ICSI successors, however, this increase did not reach statistical significance.
Conclusion: The rate of ICSI success in azospermic patients is similar to normospermic patients. TSH level in females could serve as a predictor for the outcome of ICSI.