Different strategies may be used to differentiate live immotile spermatozoa from dead ones, thus aiding in the selection of viable gametes for ICSI; Including Hyposmotic Swelling (HOS) test, Sperm tail flexibility test, Motility stimulant sperm challenge using Pentoxifylline. More recently Theophylline has been tested as a chemical tool for stimulating spermatozoa. This study was designed to compare ICSI outcome in two groups of azoospermic men subjected to testicular sperm extraction. Sperm selection for ICSI by Sperm tail flexibility test is used for the first group and chemical selection by Theophylline will be used in the second group. The present case control study included 22 obstructive azoospermic men. They were categorized into two subgroups according to method of selecting immotile but viable spermatozoa (Sperm tail flexibility test and Theophylline). The median time needed for sperm selection in all patients in the study group was highly significant less than that needed for the control group, 15.5 versus 34.5 minutes (P<0.001). Median time for single sperm isolation was highly significant less in study group than in control group, 2.1 versus 5.21 minutes (P<0.001).Additionally, clinical pregnancy outcome was highly significantly higher in the study group than in the control group, P<0.001. Theophylline reduced significantly the time needed for sperm isolation from fresh testicular samples, upgraded embryo quality, increased significantly implantation rate in ICSI and increased significantly biochemical and clinical pregnancy outcome in ICSI procedures as an assisted reproductive technique carried out on azoospermic male patients.
 

Download Full Text - PDF