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Updated: Jan 31, 2026

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
Open epididymal spermatozoa aspiration for obstructive azoospermia
Joost M Blok1, Caren van Roekel1, Ralph J A Oude Ophuis2
1Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Open epididymal spermatozoa aspiration (OESA) is a reliable surgical sperm retrieval method for men with obstructive azoospermia (OA). This technique, followed by intracytoplasmic sperm injection (ICSI), shows a 76.6% sperm retrieval rate and a 50.8% pregnancy rate.
Area of Science:
- Reproductive Medicine
- Andrology
- Surgical Techniques
Background:
- Obstructive azoospermia (OA) affects male fertility, necessitating assisted reproductive technologies.
- Surgical sperm retrieval (SR) techniques vary in efficacy for intracytoplasmic sperm injection (ICSI).
- Open epididymal spermatozoa aspiration (OESA) is a developed surgical sperm retrieval method.
Purpose of the Study:
- To evaluate the sperm retrieval rate (SRR) of OESA.
- To assess reproductive and neonatal outcomes following OESA and ICSI.
- To identify predictors of successful SR and clinical pregnancy.
Main Methods:
- Retrospective analysis of 231 men undergoing OESA for obstructive azoospermia.
- Sperm retrieval rate (SRR) calculation.
- Multivariable analysis to determine predictors of SR and pregnancy.
Main Results:
- An overall SRR of 76.6% was achieved with OESA.
- Serum FSH levels negatively predicted successful SR (OR 0.87).
- Clinical pregnancy rate was 50.8%; higher age and frozen embryo transfer were negative predictors.
Conclusions:
- OESA is a reliable and safe method for surgical sperm retrieval in men with OA.
- OESA followed by ICSI offers a viable option for achieving pregnancy.
- Further research into predictors may optimize outcomes.
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