Successful Pregnancy in a Case of Azoospermia from Congenital Bilateral Absence of Vas Deferens (CBAVD) Using Percutaneous Epididymal Sperm Aspiration (PESA) and Intracytoplasmic Sperm Injection (ICSI)
KAMTHORN PRUKSANANONDA, M.D.*, VICHUDA AHNONKITPANICH, M.Sc.*, PRAMUAN VIRUTAMASEN, M.D.* SOMCHAI SUWAJANAKORN, M.D.*, WISUT BOONKASEMSANTI, M.D.*,
Affiliation : *Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University. Bangkok 10330. Thailand.
Abstract
In men with obstructive azoospermia, bypass surgery would obviously be the most
acceptable form of treatment as it gives the couple an opportunity to conceive naturally. However,
when this has failed to restore patency or when surgery is not feasible (congenital absence of vas),
fertility treatment using spermatozoa aspirated from the epididymis should be considered. Per-
cutaneous epididymal sperm aspiration (PESA) is more acceptable to patients than micro epidi-
dymal sperm aspiration (MESA) because it eliminates the requirement for a general anaesthetic.
post-operative pain, and the risk of haematoma formation, thus allowing a rapid return to normal
activity of the husband.
To our knowledge, this is the first reported case in Thailand where a pregnancy resulted
in a couple whose infertility was due to azoospermia from the congenital absence of vas
deferens. Spermatozoa collected through PESA were used in ICSI to achieve fertilization. The
PESA technique, due to its simplicity is the choice of treatment for obstructive azoospermia.
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