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To explore whether the presence of azoospermia factor c (AZFc) microdeletions adversely affects intracytoplasmic sperm injection (ICSI) outcome. Retrospective cohort. University hospital. A total of 293 patients with azoospermia or severe oligozoospermia AZFc deletions underwent 345 ICSI cycles, and 363 idiopathic patients with normal Y chromosome underwent 462 ICSI cycles. Testicular sperm aspiration, microdissection testicular sperm extraction. The main clinical outcome parameters were cumulative clinical pregnancy rate, cumulative li