Abstract
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 1
st January 2015 to 1st January 2019 were included. Demographic data of couples
and hormonal assays results were recorded. Data included such as number of oocytes 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.
Keywords: ICSI, pregnancy rate, Fertilization rate, Oocytes, IVF
