Your experience with ICSI
2 Replies
sblanton2 - November 14

Dr. Jacobs,
I have a question regarding your experience with ICSI. My husband has obstructive azoospermia, he had a testicular biopsy showing he is producing healthy mature sperm. We were told that b/c his blockage was so old(20 yrs related to scar tissue from a surgery to remove his left testicle at age 17, non cancerous tumor) that to try to repair the tube and wait for nature to take its course was impractical(his body is producing antibodies).
My question is that since he is producing mature sperm isn't it reasonable to assume the clinic will use Mesa to extract(which should produce mature sperm) would using mature sperm vs. sperm from his testicular tissue raise our chances of success? Or would the odds be about the same? Our clinic has told us that our chances are pretty good about 50% of success.....just trying to get an idea of your experience with this. I am a little confused. I know the dna from the sperm kicks in on day 3 after fertilization so it makes sense to me if mature sperm are used vs. immature our chances would be better. I have read articles lately that chances of success with ICSI are about 20 to 30% due to immature sperm being used. Please help me understand.

Thank you,


Barry Jacobs, M. D. - November 14

You do NOT obtain mature sperm with MESA. The sperm obtained are immature, and will not fertilize eggs, unless they are injected into eggs (ICSI). If your husband was born with an obstructed vas, he has a variant of cystic fibrosis. You will need to be tesed to be sure you are not a carrier. If he is effected, and you are a carrier, your children have a 50% probability of having the disease. I cannot speak for ICSI pregnancy rates in other programs. Our ICSI pregnancy rates are almost the same as routine IVF. We get a positive pregnancy test about half the time we put embryos into a uterus.
Good luck.


sblanton2 - November 15

My dh was not born with obstructed vas defrens.....he had a surgery to remove one of his testicles at age 17 and the urologist said scar tissue from that surgery 20 yrs ago is what is causing the obstruction. He had a tumor in his testicle(back in 1988) and the doctor thought it best to remove the entire testicle rather than wait to find out if the tumor were cancerous. It was not.
We have both been tested for CF and neither of us have it or are carriers. In all the testing the best they have come up with is that after his surgery he has scar tissue build up.
Thank you for your info I was worried that we were paying for an almost miniscule chance of conceiving. Your numbers are consistent with what I have been told by my clinic.




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