[Intracytoplasmic injection of epididymal and testicular sperm after failed heterologous insemination].

We report on our experiences with intracytoplasmic injection (ICSI) of epididymal and testicular spermatozoa (MESA, TESE) from azoospermic men whose wives had previously failed to become pregnant after several cycles of artificial insemination by donor (AID); because we do not perform AID treatment in our clinic, all these treatments were carried out in other fertility centers as well as the female diagnostic of sterility. In 3 husbands we could not find any testicular spermatozoa or spermatids, leaving 15 women under treatment. Of these 15 women, 9 became pregnant. This accounts for a pregnancy rate per patient of 60%. We believe that functional defects of the oocytes and somatizing psychological problems concerning AID are predominantly responsible for these results and that both problems can be overcome by ICSI. Besides, these results demonstrate that ICSI/MESA and ICSI/TESE are effective approaches in the treatment of azoospermic men and that using cryopreserved spermatozoa is not disadvantageous in the outcome of ICSI.