CUMULATIVE EXPERIENCE OF PERCUTANEOUS EPIDIDYMAL SPERM ASPIRATION (PESA) WITH INTRACYTOPLASMIC SPERM INJECTION

Objective: Our objective was to evaluate the recovery rate of spermato zoa from the epididymis using a percutaneous aspiration technique and to assess the fertilisation rate after intracytoplasmic sperm injectio n. Materials and Methods: Fifty-four patients with azoospermia had a t otal of 59 cycles at NF with intracytoplasmic sperm injection (ICSI). The cause of the azoospermia was failed vasectomy reversal in 23 cases , congenital absence of the vas in 22 cases, partial testicular failur e in 5 cases, and retrograde ejaculation in 2 cases, while the remaini ng 2 patients had erectile disorders. Results: A total of 741 oocytes was collected and 521 metaphase II oocytes were subsequently microinje cted. Normal fertilisation occurred in 274 oocytes (52.6%), and of the se, 234 cleaved (85.4%). In 54 cycles, embryo transfer of more than on e embryo occurred (91.5%) and a total of 155 embryos was replaced. The pregnancy rate was 30.5% per cycle and 33.3% per embryo transfer. The implantation rate was 14.2%; failure of fertilisation occurred in two cycles, while in three other cycles the embryos did not cleave. Concl usions Percutaneous epididymal sperm aspiration can be used successful ly to retrieve sperm in men with azoospermia due to obstructive, or no nobstructive, disorders. The technique is simple, cost-effective, and associated with fewer complications than an open microsurgical operati on.