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Semen cryopreservation is an essential biotechnology in canine reproduction and during the cryopreservation process commonly egg yolk are used. The discrepancy in the egg yolk composition and the potential risk of disease dissemination are obstacles for semen exportation and use. Therefore, studies aiming to substitute egg yolk are extremely important. In this context, soy lecithin contains a low-density lipoprotein fraction, is an interesting alternative. Thus, the objective of this study was to compare extenders based on soy lecithin (several concentrations and forms) with egg yolk during the cryopreservation process of dog sperm. For this purpose, we used twelve dogs. Semen was evaluated at different time points (after refrigeration, glycerolization, and thawing), by motility analysis (CASA) and functional tests (e.g., membrane integrity-eosin/nigrosin, acrosome integrity-fast green/Bengal rose, mitochondrial activity-3'3 diaminobenzidine, Chromatin susceptibility to acid-induced denaturation-SCSA, and susceptibility to oxidative stress-thiobarbituric acid reactive substances). The results indicated that egg yolk and lower concentrations of lecithin had similar effects on mitochondrial activity and motility. Thus, soy lecithin is a potentially viable alternative to egg yolk for the cryopreservation of dog semen.

Taurine bulls are highly susceptible to heat stress, leading to increased oxidative stress (OS) and impaired sperm viability. Polyunsaturated fatty acids (PUFAs) supplementation can be an alternative to improve semen quality, which also results in more sperm susceptibility to lipid peroxidation. Moreover, this deleterious effect can be exacerbated in animals affected by heat stress. Vitamin E is a key antioxidant that counteracts lipid peroxidation of sperm membrane caused by OS. Thus, combining PUFAs with vitamin E may improve sperm quality. In this context, this study aimed to evaluate the effect of interaction between PUFAs and vitamin E on sperm quality in Bos taurus bulls under testicular heat stress. Sixteen taurine bulls under testicular heat stress were randomly assigned in four groups: Control, Vitamin E, PUFA, and PUFA + Vitamin E. All groups lasted for 60 days. Samples were cryopreserved/thawed and analyzed for motility variables (CASA), membrane and acrosome integrity, mitochondrial activity, susceptibility to oxidative stress, DNA integrity, and sperm-binding capacity. Results showed that vitamin E had a beneficial effect on some sperm characteristics, whereas PUFA supplementation had an adverse effect when the two treatments were evaluated separately. Finally, the association between PUFAs and vitamin E did not improve sperm quality.

The aim of this study was to evaluate the distribution of DDT and metabolites in surface soils and soil profiles from two areas containing deposits of obsolete pesticides in Belém, Amazon Region, Brazil. DDT and metabolites were extracted by microwave assisted extraction and analyzed by gas chromatography with electron capture detection. Concentrations of total DDT in surface soil samples ranged from 64.22 mg kg -1 in area 1 (A1) to 447.84 mg kg -1 in area 2 (A2). Lower levels were found in soil profiles than at the surface (6.21-21.17 mg kg -1 in A1 and 36.13-113.66 mg kg -1 in A2). pp'-DDT, pp'-DDE and pp'-DDD were detected in sediments at levels of 2.01, 0.96 and 0.35 mg kg -1 , respectively. The ratio (DDE + DDD)/ΣDDT was low indicating the recent introduction of DDT to the environment in the two study areas, through the volatilization and atmospheric deposition of the obsolete pesticides.

Introduction: The use of reliable, valid and precise skinfold calipers are key for an adequate anthropometric evaluation and corporal composition analysis. Objective: To compare five models of skinfold calipers -Prime Vision (PV); Harpenden (HP); Sanny (SN); Cescorf (CE); Lange (LA)-. Materials and methods:Thirty-five men (age = 21.5 ± 2.7 y; body mass 72.2 ± 8.0 kg; height 1.76 ± 0.06 m) were recruited and skinfolds (i.e.,triceps, biceps, subscapular, pectoral, mid-axillary, suprailiac, abdominal, mid-tight, mid-calf) were measured. Four body fat predictive equations (Durnin y Wimberley; Pollock 3DC; Pollock 7DC; Petroski) were used. Normality assumption for all data was verified with the Shapiro-Wilk test. Predicted body density and fat were compared between skinfold calipers using a two-way ANOVA, with Scheffe post hoc procedures. The αlevel was set at p ≤ 0.05 for statistical significance. Results: No significant differences were observed between skinfold calipers for predicted body density or body fat. Conclusion: Skinfold calipers compared in this study are precise and efficient to quantify and assess body density and body fat.

OBJECTIVE to elaborate and validate a proposal for a nursing care plan in people hospitalized with AIDS, in an infectious disease unit, using ICNP® version 2015. METHODS A cross-sectional study, followed by validation of content, performed with 20 nurses and 120 people, living with AIDS in an infectious disease unit of a hospital of infectious diseases in Northeast Brazil. The methodological trajectory was carried out in the following stages: elaboration of the diagnosis, nursing outcomes; Initial proposal of nursing interventions; Preparation of a care plan; And validation of the plan by field experts. RESULTS 42 diagnoses were elaborated and validated, 33 presented CVI > 0.80 (55.42%) among field experts. From this quantitative, 228 interventions were elaborated and 41 obtained a CVI > 0.80 (44.78%), considered validated. CONCLUSION The study allowed us to identify and validate nursing diagnoses, outcomes and interventions for the use in clinical practice, aiming to subsidize the process of care for people with AIDS.

The increasing production of silver nanoparticles (AgNPs) and titanium dioxide nanoparticles (TiO 2 NPs) has resulted in their elevated concentrations in the environment. This study was, therefore, aimed at determining the distribution, redox parameters, and genotoxic effects in male Wistar rats that were treated with either AgNP or TiO 2 NP individually, as well as under a co-exposure scenario. Animals were exposed via oral gavage to either sodium citrate buffer (vehicle), 0.5 mg/kg/day TiO 2 NP, 0.5 mg/kg/day AgNP or a mixture of TiO 2 NPs and AgNPs. Exposure lasted 45 days after which rats were sacrificed, and tissue biodistribution of Ag and Ti measured. The blood concentration of glutathione (GSH) and activities of glutathione peroxidase (GPx) and catalase (CAT) were determined while the genotoxicity was analyzed using the comet assay in peripheral blood and liver cells. The tissue concentrations of Ag followed the order; blood > liver > kidneys while for Ti the order was kidneys > liver > blood. There was no significant change in the measured redox parameters in animals that were exposed to TiO 2 NPs. However, there was a significant increase in GSH levels accompanied by a reduction in the GPx activity in AgNP-treated and co-exposed groups. The individual or co-exposure to TiO 2 NP and AgNP did not markedly induce genotoxicity in blood or liver cells. Data showed that TiO 2 NP did not produce significant oxidative stress or genotoxicity in rats at the dose used in this study while the same dose level of AgNPs resulted in oxidative stress, but no noticeable adverse genotoxic effects.

Objective: To check the efficacy of two types of commercially available embryo culture medium: G1-PLUS™/G2-PLUS™ sequential (Vitrolife, Gothenburg, Sweden) and GV BLAST™ sole (Ingamed, Maringá, Brazil) with regards to fertilization, cleavage, blastocyst and pregnancy rates., Methods: Prospective and randomized study conducted from March to July 2015, using the medical records of 60 patients submitted to Intracytoplasmic Sperm Injection techniques (ICSI). Data regarding the age of patients, together with fertilization, cleavage, blastocyst and pregnancy rates, were collected and compared in relation to the: G1-PLUS™/G2-PLUS™ sequential and GV BLAST™ sole mediums. The data were tabulated and compared using the Pearson's Chi-Square test (95% CI)., Results: There was no significant difference when comparing patients divided into higher and lower fertility age. No significant statistical difference was noted between the fertilization rates (P=0.59), cleavage (P=0.91), evolution to blastocyst (P=0.33) and total pregnancy (P=0.83) when comparing the embryos cultured in the different media analysed., Conclusion: We conclude that the G1-PLUS™/G2-PLUS™ sequential and GV BLAST™ sole mediums are equally effective with regards to fertilization, cleavage, blastocyst development and total pregnancy rates.

Background: Numerous studies have described the use of biofeedback therapy for the treatment of anismus. Success rates vary widely, but few data are available regarding factors predictive of success., Objective: Our aim was to evaluate short-term results of biofeedback associated with diet in patients with obstructed defecation because of anismus and to investigate factors that may affect the results., Design: Patients were identified from a single-institution prospectively maintained database., Settings: This study was conducted in a tertiary hospital., Patients: Consecutive patients who had obstructed defecation associated with anismus and were treated with biofeedback associated with diet were eligible., Interventions: Each patient underwent anal manometry and/or dynamic anal ultrasound. Patients with anismus and were treated with biofeedback associated with diet., Main Outcome Measures: Patients classed as having a satisfactory response to therapy and those classed as having an unsatisfactory response were compared with regard to sex, age, Cleveland Clinic Florida constipation score, functional factors (anal resting and squeeze pressures and reversal of paradoxical puborectalis contraction on manometry), and anatomic factors in women (history of vaginal delivery, number of vaginal deliveries, menopause, hysterectomy, and previous anorectal surgery)., Results: A total of 116 patients were included (75 women and 41 men). Overall, 59% were classed as having a satisfactory response (decrease in constipation score, >50%). Patients with satisfactory responses to biofeedback plus diet did not differ from those with unsatisfactory responses with regard to clinical, anatomic, and physiological factors., Limitations: This was not a randomized controlled trial., Conclusions: Biofeedback combined with diet is a valuable treatment option for patients with obstructed defecation syndrome associated with anismus, and more than half of our patients of both sexes achieved a satisfactory response. Improvement was not related to reversal of paradoxical contraction of puborectalis muscles at manometry. Patient sex, age, previous anorectal surgery, anorectal manometry pressures, and vaginal delivery, menopause, and hysterectomy in women did not significantly affect outcome.

Background: Immune response has been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD) and asthma. Pentraxin 3 (PTX3) is a multifunctional pattern recognition protein and an important component of the innate immune system that can be assessed in blood and induced sputum., Objective: To determine whether PTX3 measured in induced sputum could discriminate patients with COPD from patients with asthma., Methods: A cross-sectional study of 68 participants (27 with COPD, 25 with asthma, and 16 healthy controls) was performed. At study inclusion sputum was collected and total and differential cell numbers and PTX3 levels were determined., Results: Pentraxin 3 was detected in 89% of patients with COPD, 56% of patients with asthma, and 19% of controls (P = .001). It discriminated participants with COPD (24.6 ng/mL, 0-384 ng/mL) from controls (0 ng/mL, 0-36 ng/mL, P < .001) and from participants with asthma (1.2 ng/mL, 0-100 ng/mL, P = .01; area under the receiver operating curve 0.82 [0.71-0.94]). Regression analyses determined that sputum PTX3 and neutrophil counts were independently associated with COPD. In addition, PTX3 levels were independently associated with COPD severity., Conclusion: Pentraxin 3 sputum levels are increased in patients with COPD and has good power to discriminate these patients from patients with asthma and healthy individuals., (Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Objective: To determine the reliability of a rapid hematology stain for the cytological analysis of induced sputum samples., Methods: This was a cross-sectional study comparing the standard technique (May-Grünwald-Giemsa stain) with a rapid hematology stain (Diff-Quik). Of the 50 subjects included in the study, 21 had asthma, 19 had COPD, and 10 were healthy (controls). From the induced sputum samples collected, we prepared four slides: two were stained with May-Grünwald-Giemsa, and two were stained with Diff-Quik. The slides were read independently by two trained researchers blinded to the identification of the slides. The reliability for cell counting using the two techniques was evaluated by determining the intraclass correlation coefficients (ICCs) for intraobserver and interobserver agreement. Agreement in the identification of neutrophilic and eosinophilic sputum between the observers and between the stains was evaluated with kappa statistics., Results: In our comparison of the two staining techniques, the ICCs indicated almost perfect interobserver agreement for neutrophil, eosinophil, and macrophage counts (ICC: 0.98-1.00), as well as substantial agreement for lymphocyte counts (ICC: 0.76-0.83). Intraobserver agreement was almost perfect for neutrophil, eosinophil, and macrophage counts (ICC: 0.96-0.99), whereas it was moderate to substantial for lymphocyte counts (ICC = 0.65 and 0.75 for the two observers, respectively). Interobserver agreement for the identification of eosinophilic and neutrophilic sputum using the two techniques ranged from substantial to almost perfect (kappa range: 0.91-1.00)., Conclusions: The use of Diff-Quik can be considered a reliable alternative for the processing of sputum samples.

In chronic schistosomiasis, hepatic fibrosis is linked to the portal hypertension that causes morbidity in Schistosoma mansoni infection. Silymarin (SIL) is a hepatoprotective and antioxidant medicament largely prescribed against liver diseases that has previously been shown to prevent fibrosis during acute murine schistosomiasis. Here we employed silymarin to try to reverse established hepatic fibrosis in chronic schistosomiasis. Silymarin or vehicle was administered to BALB/c mice every 48 h, starting on the 40th (80 days of treatment), 70th (50 days), or 110th (10 days) day postinfection (dpi). All mice were sacrificed and analyzed at 120 dpi. Treatment with silymarin reduced liver weight and granuloma sizes, reduced the increase in alanine aminotransferase and aspartate aminotransferase levels, and reduced the established hepatic fibrosis (assessed by hydroxyproline contents and picrosirius staining). Treatment with silymarin also reduced the levels of interleukin-13 (IL-13) in serum and increased the gamma interferon (IFN-γ)/IL-13 ratio. There was a linear correlation between IL-13 levels in serum and hydroxyproline hepatic content in both infected untreated and SIL-treated mice, with decreased IL-13 levels corresponding to decreased hydroxyproline hepatic contents. Treatment with either SIL or N-acetylcysteine reduced both proliferation of fibroblast cell lines and basal/IL-13-induced production of collagen I, indicating that besides inhibiting IL-13 production during infection, SIL antioxidant properties most likely contribute to inhibition of collagen production downstream of IL-13. These results show that silymarin interferes with fibrogenic cytokines, reduces established fibrosis, and inhibits downstream effects of IL-13 on fibrogenesis, indicating the drug as a safe and cheap treatment to liver fibrotic disease in schistosomiasis.

Polycyclic aromatic hydrocarbons (PAHs) were determined in water samples collected in two streams and a lake located at Niteroi City, Rio de Janeiro State, Brazil between October 2008 and September 2009. Samples were extracted using liquid-liquid extraction and analyzed using high performance liquid chromatography with fluorescence detection. The limits of quantification were sufficiently low to accomplish PAH determination below the maximum concentration levels established by the Brazilian (50 ng/L) and USEPA legislations, with recoveries larger than 81.6%. Phenanthrene, fluoranthene, pyrene and benz[a]anthracene predominated among PAHs. Total concentrations of PAHs were well correlated with rainfall indicating a possible role of runoff to local pollution of water by PAHs and showed a seasonal variation in wet and dry seasons. Our results highlight the contribution of the widespread streams located around Guanabara Bay to the PAH burden found in its waters., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: To establish reference values for cellularity in induced sputum samples collected from healthy adults., Methods: Induced sputum samples were obtained from 88 healthy adult never-smokers (39 males). The mean age was 36 years (range, 18-68 years). The participants had been residing in the city of Florianópolis, Brazil (a medium-sized non-industrial city) for at least two years. After the samples had been processed, we obtained total and differential cell counts., Results: The mean total cell count was 4.8 ± 4.2 × 10(6) cells/g. There was a predominance of macrophages (mean, 77.5 ± 14.7%) and neutrophils (mean, 23.4 ± 14.3%). Eosinophils were virtually absent (mean, 0.1 ± 0.3%). Lymphocytes and bronchial epithelial cells were scarce. Neither age nor atopy had any effect on the total or differential cell counts., Conclusions: In the induced sputum of this healthy adult population, macrophages and neutrophils predominated. However, the proportion of neutrophils was lower than that reported in previous studies, which suggests that reference values might vary depending on geographic location.

Objective: The translation and cross-cultural adaptation of a specific scoring instrument for the comprehensive control of asthma, the Asthma Control Scoring System (ACSS), for use in Brazil., Methods: The protocol included ten steps: acquisition of written permission from the author of the ACSS; translation of the instrument to Brazilian Portuguese, carried out by three separate translators; analysis and comparison of the three versions by a review committee; literal back-translation to English; review and harmonization of the back-translation; acquisition of the approval of the original author; review of the translation by specialists; cognitive debriefing: test of clarity to, understanding by, and acceptance of the target population (evaluation of the translation by 10 health care workers); second cognitive debriefing: review of the revised version by a second group of health care workers; and reconciliation and preparation of the final version by the review committee., Results: The Brazilian Portuguese-language version of the ACSS showed clarity, understandability, and acceptability. The instrument was considered to be comprehensive because it includes the clinical manifestations of asthma, as well as the functional and inflammatory aspects of the disease., Conclusions: With the use of this careful methodology in the translation and cross-cultural adaptation of the ACSS, we have ensured its cultural adequacy for Brazil. The use of this instrument could facilitate future studies on asthma control.

The schistosomiasis is a parasitic infection with relevant social impact and an important health problem in many countries around world. The pathology of this infection is characterized by a granulomatous reaction around parasite eggs and by hepatic fibrosis. Silymarin, a complex compound isolated from Silybum marianum (L.) Gaertner, have been described as hepatoprotective, antioxidant, antifibrotic, immunomodulator, and anti-neoplastic agent. Some of these capacities could potentially protect against pathology in schistosomiasis. Herein, we evaluated the effects of silymarin on parasite burden, granuloma sizes, and liver fibrosis, which are associated with severity and morbidity of this disease. BALB/c mice treated intraperitoneally with 10, 20, or 25 doses of silymarin (10 mg kg(-1)) suspended in carboxymethylcellulose were analyzed at 55 days post-infection. Silymarin (1) did not affect parasite oviposition capacity; (2) reduced granulomatous peri-ovular reaction in the liver, and (3) decreased hepatic fibrosis in this infection. Taken together, these data suggest that treatment with silymarin at acute phase of schistosomiasis may result in a mild course of murine schistosomiasis and can be a promising complementary treatment reverting sequelae of this infection.

Purpose: To find an effective method to select embryos from ICSI with better chromosomal status when preimplantation-genetic-diagnosis (PGD) is not applied., Methods: Several morpholological evaluations were done in same embryos. Embryos from ICSI were classified on day 1 according to pronuclear-nucleoli arrangement. On day 3, classification was done according to number, fragmentation, size and shape of cells. In some patients, embryos exhibiting good quality on day 3 (at least six regular blastomeres with cell fragmentation lower than 20%) were also submitted to PGD, irrespective to pronuclear-nucleoli morphology., Results: Forty-two per cent of normally fertilized embryos showed pronuclear-nucleoli-good-morphology; from those, 86% were also classified as good quality on day 3. Good-quality embryos submitted to PGD have shown lower chromosomal abnormality rates when also classified as pronuclear-nucleoli-good-morphology., Conclusions: Pronuclear-nucleoli morphology seems to be correlated with PGD results. This criterion may prove useful for pre-select embryos with normal chromosomal package when PGD is not applied.

Purpose: The development of intracytoplasmic sperm injection spawned new methods of sperm retrieval for men with obstructive azoospermia who did not want to undergo reconstruction of the seminal tract. There is a wide array of different procedures that may be performed in these cases, for instance percutaneous epididymal sperm aspiration (PESA) and microepididymal sperm aspiration. However, concerns regarding the presence of sperm in a second PESA attempt due to possible fibrosis have been suggested by many authors. We evaluate if it is worthwhile to repeat percutaneous epididymal sperm aspiration., Materials and Methods: The records of 20 patients (23 attempts) who underwent repeat PESA from January 1996 to September 2000 for assisted reproductive technique purposes were reviewed. In all patients the repeat procedure was performed on the same side as the previous PESA. Data were collected on patient age, presence of motile sperm during PESA, epididymal side, pregnancies and abortion rates., Results: Mean patient age +/- SD was 32.4 +/- 5.6 years. One patient was excluded from our analysis due to lack of information on the chart regarding the side of the procedure. Repeat PESA was performed in the right epididymis in 12 attempts and in the left in 10. Of the remaining 19 patients 14 (73.68%) did not and 5 (26.3%) have sperm in the epididymal fluid. In these 5 patients 8 repeat PESA procedures were performed (3 procedures in 1 and motile sperm was always found (8 of 22 attempts, 36.4%). Three patients achieved pregnancy with the motile sperm retrieved from the repeat PESA (3 of 8 repeat attempts, 37.5%). No abortions were detected., Conclusions: More than a third of repeat PESA attempts resulted in the presence of motile sperm. Before performing testicular sperm aspiration or extraction in patients who have undergone previous PESA without achieving pregnancy, repeat PESA may be done. Further attempts should be added in the future to confirm these results.

Purpose: To evaluate the relationship between the postvasectomy period and sperm reproductive capacity after ICSI., Methods: Seventy-seven ICSI cycles with percutaneous epididymal sperm aspiration (PESA) were reviewed. Patients were divided into 4 groups according to the interval after vasectomy: 0 - 5 years (G1); 6 - 8 years (G2); 9 - 14 years (G3), and > 15 years (G4)., Results: Clinical and ongoing pregnancy rates did not correlate significantly with the time period of vasectomy until 14 years. Although the higher implantation rate observed in G1, no significant differences were noted among Groups 1-3. The miscarriage rates increased from G1 to G4, reaching a statistical significance among G1, G2, and G3 compared with G4. When groups were also divided according to the maternal age, the same results were obtained., Conclusions: The interval between the vasectomy and the sperm retrieval procedure has no effect on the outcome until the interval of 14 years.

Purpose: To analyze best parameter to select embryos according to sperm origin in ICSI cycles., Methods: One hundred seventy-two ICSI cycles were divided among three different groups: A (ejaculated spermatozoa from nonmale factor infertility), B (ejaculated spermatozoa from oligospermia), and C (spermatozoa from azoospermia). Embryos were divided on Day 1 into two patterns: S0 (pronuclei (PN) aligned and close with normal arrangement of nucleoli) and S1 (when these characteristics were absent) and also on transfer day according to morphological features., Results: Relationships of PN patterns related to sperm origin were noted. More S0 embryos were detected with better sperm quality. Higher number of good quality embryos was obtained when male factor was absent. Ejaculated and epididymal spermatozoa provide better quality embryos than do testicular spermatozoa., Conclusions: PN classification associated with transfer day morphology is valuable additional noninvasive criterion for elective embryo transfer, mainly in the cases with severe male factor.

Context: Several sperm retrieval techniques are available for use on azoospeermic men. Comparisons between spermatozoa retrieved from the testicles and epididymis 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 < 0.05). Also, motile spermatozoa had lower miscarriage rates compared to immotile spermatozoa (p < 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.

Purpose: We assessed fertilization, pregnancy and miscarriage rates in patients with obstructive and nonobstructive azoospermia who underwent intracytoplasmic sperm injection., Materials and Methods: From June 1996 to March 2000, 166 consecutive patients (198 intracytoplasmic sperm injection cycles) with azoospermia were studied. Of these 198 cycles 68 were performed due to nonobstructive azoospermia using testicular spermatozoa and 130 were performed due to obstructive azoospermia using epididymal spermatozoa., Results: The normal (2 pronuclei) and abnormal (1 plus 3 pronuclei) fertilization rates for obstructive and nonobstructive azoospermia were 60.5% and 16.6%, and 54% and 16.4%, respectively (p >0.05). The pregnancy rate per cycle, pregnancy rate per patient and abortion rate were 30%, 39.8% and 28% for obstructive azoospermia, and 22%, 28.3% and 40% for nonobstructive azoospermia (p <0.05). The normal and abnormal fertilization rates were 58.7% and 21.4% for percutaneous epididymal sperm aspiration (PESA), 62.3% and 10.4% for PESA plus testicular sperm aspiration (TESA), and 57.3% and 14.5% for TESA, respectively (p >0.05). The pregnancy rate per cycle, pregnancy rate per patient and abortion rate were 34.6%, 54.5% and 11.1% for PESA, 37.5%, 37.5% and 33.3% for PESA plus TESA, and 26.1%, 31% and 41% for TESA, respectively (PESA versus PESA plus TESA p >0.05, and PESA and PESA plus TESA versus TESA p <0.05). Epididymal or testicular motile sperm resulted in a lower abortion rate than epididymal or testicular immotile sperm (p = 0.03)., Conclusions: No differences were noted in the fertilization and embryo transfer rates irrespective of etiology (obstructive versus nonobstructive) and type of spermatozoa (epididymal versus testicular). Testicular sperm retrieval results in lower fertilization and pregnancy rates as well as higher abortion rates than epididymal sperm retrieval.