The Outcome ot" Sperm Retrieval and Intracytoplasmic Sperm Injection for Obstructive Azoospermia
NARES SUKCHAROEN, M.D.*, SAKCHAI PROMVIENGCHAI, B.Sc.**, WISUT BOONKASEMSANTI, M.D.* TIPPA WAN SITHIPRA VEJ, B.Sc. **, VIWAT CHINPILAS, M.D.**,
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkom University, ** Navabutr Center for Assisted Reproduction & Embryology, Bangkok 10330, Thailand.
Objectives : To study the outcome of sperm retrieval and intracytoplasmic sperm injec-
tion (ICSI) from obstructive azoospermic men.
Method : Overall, 50 sperm retrieval procedures were performed in 45 obstructive azoo-
spermic men, followed by 57 ICSI procedures with fresh epididymal spermatozoa (n=40), fresh
testicular spermatozoa (n=4) or frozen-thawed epididymal spermatozoa (n=13).
Results : Sperm retrieval was accomplished via percutaneous epididymal sperm aspira-
tion (PESA) in 42 cases, testicular sperm aspiration (TESA) in 1 case and testicular sperm extrac-
tion (TESE) in 2 cases. TESA and TESE were only applied when PESA failed to produce enough
spermatozoa for simultaneous ICSI. PESA was successful in 92 per cent of cases. Fertilization
rate after ICSI was 79.6 per cent of the metaphase II oocytes. Seventy one embryo transfers were
performed using both fresh and frozen thawed embryos resulting in clinical pregnancy in 39.4 per
cent. Ongoing pregnancy was achieved in 35.2 per cent.
Conclusion : ICSI has been shown to give a high fertilization and pregnancy rate with
epididymal and testicular spermatozoa retrieved from obstructive azoospermic men. PESA is a
noninvasive and simple technique for retrieving spermatozoa from obstructive azoospermic men.
Therefore~ it is suitable as the primary sperm recovery technique in patients with obstructive azoo-
spermia.
Keywords : Obstructive Azoospermia, Sperm Retrieval, Intracytoplasmic Sperm Injection, ICSI PESA,TESA,TESE
