Reply of the Authors: Testicular sperm characteristics in men with nonobstructive azoospermia and their impact on intracytoplasmic sperm injection outcome

Reply to Letter to the Editor

VOLUME 118, ISSUE 2, P427


Nahid Punjani, M.D., M.P.H., Ahmed Aboukhshaba, M.D., Sofia Doukakis, Nikica Zaninovic, Ph.D., Gianpiero D. Palermo, M.D., Ph.D., Peter N. Schlegel, M.D. 


We appreciate the interest in our article shown by Dr. Gashti. The goal of our published article was to address the question and concerns routinely raised by embryologists who analyze testicular sperm from men with nonobstructive azoospermia. In a setting of expected 0% normal morphology (1), there is often a question of the reproductive competence of these sperm. Our article documents that the appearance of sperm, with few exceptions, does not adversely affect in vitro fertilization outcomes (2). We believe that these observations will be useful for the laboratory staff facing the use of testicular sperm. Too often, assisted reproductive laboratory experts scoff at the appearance of testicular sperm and may deny men the opportunity to have their own biological children when the use of these sperm is feasible. Although men with nonobstructive azoospermia rarely have motile sperm seen at the time of retrieval, >80% of cases will acquire motility during in vitro incubation before intracytoplasmic sperm injection. Even when no motility is acquired, a pregnancy rate of 20% was observed with nonmotile injected testicular sperm.

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