We assessed the sperm retrieval rates and intracytoplasmic sperm injection outcomes, including the neonatal profile of infants conceived, in men with testicular failure. Three-hundred and sixty-five men with testicular failure who underwent microdissection testicular sperm extraction were included. We compared their outcomes with those of 40 men with testicular failure who used donor sperm for injections due to failed retrievals, and 146 men with obstructive azoospermia who underwent percutaneous sperm retrievals. The retrieval rate in testicular failure was 41.4%, and the results were lower than obstructed azoospermia (100.0%; adjusted odds-ratio: 0.033; 95% CI: 0.007 –0.164; P<0.001). Live birth rates after sperm injections were lower in men with testicular failure (19.9%) compared with donor sperm (37.5%; adjusted OR: 0.377 (95% CI: 0.233 – 0.609, P <0.001)) and obstructive azoospermia (34.2%; adjusted OR: 0.403 (95% CI: 0.241–0.676, P=0.001). Newborn parameters of infants conceived were comparable among the groups. We concluded that the chances of obtaining sperm at retrievals and achieving a live birth after intracytoplasmic sperm ICSI are reduced in men with testicular failure. The profile of infants conceived after sperm injection does not seem to be negatively affected by testicular failure.

Keywords: infant; intracytoplasmic sperm injection; obstructive azoospermia; pregnancy outcome; sperm retrieval; testicular failure

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