Live birth resulting from in-office vas deferens sperm retrieval combined with natural-cycle insemination

In-office retrieval of spermatozoa from the vas deferens was successfully combined with intra-uterine insemination of the wife during her natural cycle in the case of a man with azoospermia due to a non-correctable obstruction of the vas deferens. The combined cost of both procedures (sperm retrieval and intra-uterine insemination with processed spermatozoa) was less than $1000. The cost and convenience compare quite favourably with that of epididymis sperm aspiration combined with in-vitro fertilization, which is the currently recommended alternative treatment in such cases. These alternative therapies are compared and discussed relative to their advantages and disadvantages. Our technique for in-office vas deferens sperm retrieval is also presented.