Introduction: Our experience of ICSI began in 1997. This study reviews our four-year experience based on 42 consecutive couples.
Material and method: Between February 1997 and December 2000, 42 sterile couples due to male infertility were treated by ICSI. Surgical exploration and "open" gamete collection were proposed regardless of the predefined type of azoospermia, obstructive or non-obstructive.
Result: Seventy one cycles were performed: ICSI used epididymal spermatozoa in 49 cycles, and testicular spermatozoa in 22 cycles. The fertilization rate was 76% for fresh semen and 87% for frozen semen. The fertilization rate was 88% for epididymal spermatozoa and 68% for testicular spermatozoa. 13 pregnancies were obtained (18.3%), 11 babies were born at term including 3 twin pregnancies. No significant difference was observed between fresh and frozen semen, or between obstructive and non-obstructive azoospermia.
Conclusion: IVF-ICSI applied to sterility due to male infertility has revolutionized the management of sterile couples. However, as for any new procedure in medicine, we must be vigilant, as a sufficient follow-up is necessary to definitively evaluate the safety of ICSI, especially in terms of the risk of genetic abnormalities.