M. Tsirigotis et al., SIMPLIFIED SPERM RETRIEVAL AND INTRACYTOPLASMIC SPERM INJECTION IN PATIENTS WITH AZOOSPERMIA, British Journal of Urology, 76(6), 1995, pp. 765-768
Objective To evaluate the rate of recovery of spermatozoa from the epi
didymis using a percutaneous aspiration technique and to assess the fe
rtilization rate following intracytoplasmic sperm injection (ICSI). Pa
tients and methods Forty-two patients with azoospermia underwent a tot
al of 46 treatment cycles of in vitro fertilization (IVF) and ICSI, Th
e sperm used for ICSI was retrieved percutaneously by fine-needle aspi
ration and syringe suction (percutaneous epididymal sperm aspiration,
PESA) from the epididymis in 28 patients (mean age 34.9 years), over 3
2 cycles, Six patients underwent microsurgical sperm aspiration (MESA)
and in the remaining eight patients, neither percutaneous aspiration
nor MESA yielded suitable sperm and spermatozoa extracted from testicu
lar biopsy were used. Results A total of 362 oocytes were collected an
d of those, 286 (79%) were subjected to ICSI. Of the injected oocytes,
49 (17.2%) mere damaged, 138 (48.3%) achieved normal fertilization an
d, of those, 112 (81.2%) cleaved, A total of 67 embryos were transferr
ed and 18 more were suitable for cryopreservation, Of the 25 cycles wi
th embryo transfer, eight resulted in a pregnancy and of these, one mi
scarried. The pregnancy rate was 25% per cycle and 32% per embryo tran
sfer. The implantation rate was 12%, Conclusions This extensive series
of PESA/ICSI cycles indicates that PESA can be used successfully to r
etrieve spermatozoa in patients with azoospermia. The technique is sim
ple, cost-effective and is associated with fewer complications compare
d to an open microsurgical procedure.