{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:55:31Z","timestamp":1768006531139,"version":"3.49.0"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sao Paulo Med. J."],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:p>CONTEXT: Several sperm retrievel techniques are available for use on azoospeermic men. Comparisons between spermatozoa retrieved from the testicles and epidymis in relation to pregnancy and miscarriage rates are not well established. OBJECTIVE: To compare pregnancy and miscarriage rates using sperm retrieved from the testes and epididymis using intracytoplasmic sperm injection. Furthermore, we evaluated the fertilization and pregnancy rates according to the status of the spermatozoa retrieved (motile or immotile). DESIGN: Retrospective study. SETTING: A private center for assisted fertilization. PARTICIPANTS: One hundred and eight consecutive patients who presented with azoospermia were included in our study, on whom a total of 144 retrieval procedures were performed. PROCEDURES: Of the 144 retrieval procedures, 104 were testicular sperm aspirations (TESA) and 40 were epididymal sperm aspirations (PESA). PESA was the first approach in obstructive patients (n = 68), whereas TESA was used when the former failed. For non-obstructive patients (n = 40), TESA was the method of retrieval. MAIN MEASUREMENTS: Pregnancy and miscarriage rates according to spermatozoa characteristics (motile or immotile). RESULTS: The number of cycles performed using spermatozoa retrieved from the testicles and epididymis was 81 and 30, respectively. Motile spermatozoa had higher fertilization (2PN) and pregnancy rates compared to immotile spermatozoa (p &lt; 0.05). Also, motile spermatozoa had lower miscarriage rates compared to immotile spermatozoa (p &lt; 0.0001). No differences were seen in pregnancy rates with testicular spermatozoa (n = 28) compared to epididymal spermatozoa (n = 13) (p = 0.1). However, the miscarriages rates were higher in spermatozoa retrieved from the testicles (n = 12) compared to epididymis retrievals (n = 1) (p = 0.01). CONCLUSIONS: Although pregnancy rates were similar when the intracytoplasmic sperm injection was performed with spermatozoa retrieved from the testicles and epididymis, the use of testicular spermatozoa yields a significantly higher miscarriage rate. It is possible that the higher miscarriage rate seen in patients using spermatozoa retrieved from the testicles is linked to high genetic sperm abnormalities.<\/jats:p>","DOI":"10.1590\/s1516-31802002000400007","type":"journal-article","created":{"date-parts":[[2005,4,27]],"date-time":"2005-04-27T14:53:05Z","timestamp":1114613585000},"page":"122-126","source":"Crossref","is-referenced-by-count":17,"title":["Testicular sperm results in elevated miscarriage rates compared to epididymal sperm in azoospermic patients"],"prefix":"10.1590","volume":"120","author":[{"given":"Edson","family":"Borges J\u00fanior","sequence":"first","affiliation":[{"name":"Associa\u00e7\u00e3o Paulista de Medicina, Brazil; Centro de Fertiliza\u00e7\u00e3o Assistida, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lia Mara","family":"Rossi-Ferragut","sequence":"additional","affiliation":[{"name":"College of Medicine, Brazil; Centro de Fertiliza\u00e7\u00e3o Assistida, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e1bio Firmbach","family":"Pasqualotto","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela Regina dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Centro de Fertiliza\u00e7\u00e3o Assistida, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e1udia Chagas","family":"Rocha","sequence":"additional","affiliation":[{"name":"Centro de Fertiliza\u00e7\u00e3o Assistida, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assumpto","family":"Iaconelli J\u00fanior","sequence":"additional","affiliation":[{"name":"Centro de Fertiliza\u00e7\u00e3o Assistida, 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injection","volume":"8","author":"Van Steirteghem AC","year":"1993","journal-title":"Hum Reprod","ISSN":"https:\/\/id.crossref.org\/issn\/0268-1161","issn-type":"print"},{"issue":"5","key":"ref4","first-page":"261","article-title":"Factors affecting the success of intracytoplasmic sperm injection in cases of non-obstructive azoospermia","volume":"10","author":"Sallam HN","year":"2001","journal-title":"Reproductive Technologies"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/j.1939-4640.1993.tb00380.x","article-title":"Motile sperm in human testis biopsy specimens","volume":"14","author":"Jow WW","year":"1993","journal-title":"J Andrology"},{"issue":"1","key":"ref6","first-page":"40","article-title":"Factors of failed fertilization after intracytoplasmic sperm injection","volume":"4","author":"Moraes LAM","year":"2000","journal-title":"Jornal Brasileiro de Reprodu\u00e7\u00e3o 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as an etiologic factor in chronic airway infections and male sterility","volume":"297","author":"Eliasson R","year":"1977","journal-title":"N Engl J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1093\/oxfordjournals.humrep.a136204","article-title":"The stages at which human fertilization arrests: microtubule and chromosome configurations in inseminated oocytes that failed to complete fertilization and development in humans","volume":"10","author":"Asch R","year":"1995","journal-title":"Hum Reprod","ISSN":"https:\/\/id.crossref.org\/issn\/0268-1161","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1095\/biolreprod55.2.271","article-title":"Microtubule and chromatin configurations during rhesus intracytoplasmic sperm injection: successes and failures","volume":"55","author":"Hewitson LC","year":"1996","journal-title":"Biol Reprod","ISSN":"https:\/\/id.crossref.org\/issn\/0006-3363","issn-type":"print"},{"key":"ref12","series-title":"Towards reproductive certainty: fertility and genetics beyond 1999","volume-title":"Cytoplasmic endowment of organelles other than mitochondria","author":"Hewitson LC"},{"issue":"2","key":"ref13","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1093\/humrep\/16.2.272","article-title":"The use of a modified hypo-osmotic swelling test for the selection of viable ejaculated and testicular immotile spermatozoa in ICSI","volume":"16","author":"Sallam HN","year":"2000","journal-title":"Hum Reprod","ISSN":"https:\/\/id.crossref.org\/issn\/0268-1161","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/S0015-0282(16)54728-1","article-title":"Movement characteristics of human epididymal sperm used for fertilization of human oocytes in vitro","volume":"56","author":"Davis RO","year":"1991","journal-title":"Fertil Steril","ISSN":"https:\/\/id.crossref.org\/issn\/0015-0282","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/S0015-0282(16)54188-0","article-title":"Gonadotrophins and combined gonadotrophin-releasing hormone agonist gonadotrophin protocols in a randomized prospective study","volume":"55","author":"Ron-El R","year":"1999","journal-title":"Fertil Steril","ISSN":"https:\/\/id.crossref.org\/issn\/0015-0282","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/S0015-0282(16)55326-6","article-title":"Poor in vitro fertilization outcome with semen yielding low sperm density \"swim-ups\" is not because of altered sperm motion parameters","volume":"58","author":"Thanki KH","year":"1992","journal-title":"Fertil. Steril","ISSN":"https:\/\/id.crossref.org\/issn\/0015-0282","issn-type":"print"},{"key":"ref17","first-page":"36","article-title":"Development and blastocyst formation","volume":"38","author":"Janny I","year":"1994","journal-title":"Mol Rep Dev"},{"issue":"8","key":"ref18","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1023\/A:1009413201849","article-title":"Very low sperm count affects the result of intracytoplasmic sperm injection","volume":"17","author":"Strassburger D","year":"2000","journal-title":"J Assist Reprod Gen"},{"key":"ref19","first-page":"577","article-title":"Genetic risks associated with intracytoplasmic sperm injection","volume":"24","author":"Plachot M","year":"1996","journal-title":"Contracept Fertil Sex","ISSN":"https:\/\/id.crossref.org\/issn\/1165-1083","issn-type":"print"},{"issue":"5","key":"ref20","first-page":"988","article-title":"Developmental changes in methylation of spermatogenesis-specific genes includes reprogramming in the epididymis","volume":"15","author":"Ariel M","year":"2000","journal-title":"Nature Genet 1994;7:59-63. Cited in: Tsai MC, Takeuchi T, Bedford JM, et al. Alternative sources of gametes: reality or science fiction? Hum Reprod"},{"key":"ref21","author":"Yamasaki R","year":"1999"},{"issue":"2","key":"ref22","first-page":"60","article-title":"Chromosome evaluation of infertile men prior to intracytoplasmic sperm injection","volume":"4","author":"Almodin CG","year":"2000","journal-title":"Jornal Brasileiro de Reprodu\u00e7\u00e3o Assistida"},{"key":"ref23","first-page":"772","article-title":"Spermatid injection into human oocytes","volume":"11","author":"Tesarik J","year":"1996","journal-title":"I. Laboratory techniques and special features of zygote development. 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