Table 4.
Studies Comparing Pregnancy Outcomes after Intracytoplasmic Sperm Injection using Surgically-retrieved Spermatozoa in Men with Obstructive and Nonobstructed Azoospermia.
| Authors; Year (reference) | Design | Region | OA vs. NOA; number of cycles | Control group of ejaculated sperm; yes/no; No. cycles | Most relevant pregnancy outcome assessed | Main findings | Other findings |
| Aboulghar et al.; 1997 (21) | Retrospective | Egypt | 126 vs. 80 | Yes; 102 | CPR | Lower CPR for NOA compared with other groups | Miscarriage rate and multiparity rates presented but not compared |
| Ghazzawi et al. 1998 (22) | Prospective | Jordan | 19 vs. 30 | Yes; 28 | LBR | Lower LBR when testicular sperm from men with NOA was used (10%) compared with ejaculated (21%) or epididymis (22%) | Increased miscarriage rate when testicular sperm from NOA men were used |
| Ubaldi et al.; 1999 (23) | Prospective controlled | Italy | 33 vs. 29 | Yes; 62 | Ongoing pregnancy and LBR | Similar results among groups | Implantation rate lower in NOA (13.4%) vs. ejaculated sperm or OA (∼26%) |
| Palermo et al.; 1999 (24) | Retrospective | USA | 255 vs. 53 | No | LBR | Lower LBR with testicular sperm from NOA vs. epididymal sperm from OA | Similar malformation rate between groups |
| De Croo et al.; 2000 (25) | Retrospective | Belgium | 139 vs. 54 | No | LBR | Similar LBR between OA (16.2%) and NOA (22.6%) | Miscarriage and multiparity described but not compared |
| Bukulmez et al.; 2001 (26) | Retrospective | Turkey | 43 vs. 53 | Yes; 780 | CPR | No difference in outcome | NR |
| Schwarzer et al. 2003 (27) | Retrospective | Germany | 300 vs. 414 | No | LBR | Lower LBR in NOA (19%) vs. OA (28%) | NR |
| Ghanem et al.; 2005 (28) | Case series and meta-analysis of cohort studies | Egypt | 48 vs. 42 | No | CPR | Similar CPR between OA (25%) and NOA (23.1%) | Lower fertilization rate in NOA |
| La Sala et al.; 2006 (29) | Retrospective | Italy | NA | NA | CPR | Similar CPR in OA (12.9%) vs. NOA (15.4%) | NR |
| Verza Jr & Esteves; 2008 (15) | Retrospective | Brazil | 39 vs. 54 | Yes; 220 | CPR | Lower pregnancy rates (25.9%) in NOA compared with OA (51.3%) and ejaculated sperm (36.6%) | Miscarriage rates did not differ between groups |
| Semião-Francisco et al.; 2010 (30) | Retrospective | Brazil | 274 vs. 102 | No | CPR | No differences in CPR between groups | Higher miscarriage rate in OA with the use of testicular sperm compared with epididymal sperm |
| He et al., 2010 (31) | Retrospective | China | 112 vs. 42 | No | CPR | Lower CPR in NOA (21.4%) than OA (40.2%) | Similar miscarriage rates |
AO = obstructive azoospermia; NOA = nonobstructive azoospermia; LBR = live birth rate; CPR = clinical pregnancy rate; NR = not reported; NA = not available.