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Related Experiment Videos

[Epididymal sperm aspiration for obstructive azoospermia].

H Okuno1, E Nakamura, Y Shichiri

  • 1Department of Urology, Graduate School of Medicine, Kyoto University.

Hinyokika Kiyo. Acta Urologica Japonica
|October 6, 2000
PubMed
Summary

Microsurgical epididymal sperm aspiration (MESA) and percutaneous epididymal sperm aspiration (PESA) offer effective options for treating obstructive azoospermia with assisted reproductive technology (ART). MESA demonstrated higher sperm retrieval rates, while PESA provides a convenient outpatient procedure.

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Area of Science:

  • Reproductive Medicine
  • Andrology
  • Urology

Context:

  • Obstructive azoospermia, including congenital bilateral absence of the vas deferens and failed surgical interventions, presents a significant challenge in male infertility.
  • Assisted reproductive technology (ART), particularly intracytoplasmic sperm injection (ICSI), has revolutionized treatment possibilities.
  • Epididymal sperm aspiration techniques provide a viable alternative for sperm retrieval in cases of non-obstructive azoospermia.

Purpose:

  • To evaluate the efficacy of epididymal sperm aspiration techniques, specifically microsurgical epididymal sperm aspiration (MESA) and percutaneous epididymal sperm aspiration (PESA), in conjunction with ART for treating obstructive azoospermia.
  • To compare the sperm retrieval rates and subsequent pregnancy outcomes between MESA and PESA procedures.
  • To assess the feasibility and success of using retrieved epididymal sperm for ICSI.

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Summary:

  • Epididymal sperm aspiration, including MESA and PESA, was performed in 36 cases combined with ART/ICSI.
  • MESA achieved a 94.4% motile sperm retrieval rate, while PESA yielded a 50% retrieval rate.
  • MESA-ICSI resulted in a 47.3% fertilization rate and a 28.8% pregnancy rate per transfer, with PESA offering a convenient outpatient option.

Impact:

  • These findings highlight MESA and PESA as effective methods for sperm retrieval in obstructive azoospermia, expanding ART options for infertile men.
  • The study underscores the importance of considering female fertility potential and age when discussing male treatment outcomes.
  • Advancements in ICSI, including the use of frozen sperm, allow for elective and convenient sperm retrieval planning.