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[Percutaneous sperm retrieval for ICSI procedures in men with obstructive azoospermia: ICSI-PESA and ICSI-TESE
J K Wolski1, K Kozioł, P Lewandowski
1Prywatnej Przychodni Leczenia Niepłodności Novum, Warszawa.
Objectives:
The sperm retrieval for ICSI procedures is possibly using following procedures: ejaculate sperm, epididymal sperm obtained by microsurgical aspiration or percutaneous puncture and testicular sperm that are obtained by surgical excision or percutaneous biopsy. Percutaneous techniques seem to be rather simple and effective procedures.
Design:
The authors present their own experiences with percutaneous sperm retrieval for micromanipulation ICSI from the epididymis (ICSI-PESA) and from the testicular tissue (ICSI-TESE) in men with obstructive azoospermia and with reactive impotence. First time in Poland ICSI-PESA was done on April 11, 1996 in Private Infertility Center "Novum", Warsaw.
Material And Methods:
From April 1996 to the end of January 1998, 10 ICSI-PESA procedures (in 9 couples) and 8 ICSI-TESE (in 6 couples) were performed. In one case ICSI-PESA was performed in man with psychological inability of masturbation during his wife's IVF protocol. All procedures were performed as the day case urology, under general anesthesia. The fine needles No 6 in PESA or biopsy needle from Hepafix Set B. Braun in TESE were used. The therapy of antibiotic and common analgesic drug was used routinely after puncture.
Results:
The effectiveness of obtaining sperm for micromanipulation were 100% ICSI-PESA and 75% ICSI-TESE. The pregnancy rate in PESA was 50% and 5 healthy children were born. In TESE only 1 woman (17%) was pregnant, but early spontaneous miscarriage was reported. No surgical and anesthesiological complications were noticed.
Conclusions:
Obtaining sperm for micromanipulation ICSI using percutaneous epididymal puncture or testicular tissue needle biopsy seems to be effective and safe for patients with obstructive azoospermia or reactive impotence.
Insights
Percutaneous sperm retrieval techniques, including ICSI-PESA and ICSI-TESE, are effective for obtaining sperm for intracytoplasmic sperm injection (ICSI). These minimally invasive methods offer a safe and successful option for men with obstructive azoospermia or reactive impotence.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Context:
- Sperm retrieval is crucial for Intracytoplasmic Sperm Injection (ICSI) in infertile men.
- Percutaneous techniques offer minimally invasive alternatives to surgical sperm retrieval.
- Obstructive azoospermia and reactive impotence present challenges for natural conception.
Purpose:
- To evaluate the effectiveness and safety of percutaneous sperm retrieval techniques for ICSI.
- To compare ICSI with percutaneous epididymal sperm aspiration (ICSI-PESA) and ICSI with testicular sperm extraction (ICSI-TESE).
Summary:
- Percutaneous sperm retrieval, including ICSI-PESA and ICSI-TESE, demonstrated high success rates in obtaining sperm for micromanipulation.
- ICSI-PESA achieved 100% sperm retrieval effectiveness with a 50% pregnancy rate and live births.
- ICSI-TESE had a 75% sperm retrieval rate, resulting in one pregnancy with early miscarriage; no complications were reported for either procedure.
Impact:
- Percutaneous sperm retrieval is a safe and effective option for patients with obstructive azoospermia or reactive impotence undergoing ICSI.
- These minimally invasive techniques provide viable fertility solutions, contributing to successful assisted reproductive technologies.
- The study highlights the potential for percutaneous methods to improve outcomes in male infertility treatment.