EPIDIDYMAL AND TESTICULAR SPERMATOZOA RET RIEVAL FOR INTRACYTOPLASMATIC MICROINJECTION

Male infertility caused by obstruction of the seminal ducts can be tre ated using mircosurgical refertilization techniques. In the case of no n-reconstructable obstructions, microsurgical epididymal sperm aspirat ion (MESA) or testicular sperm aspiration (TESE), both in conjunction with an intracytoplasmatic spermatozoa injection (ICSI) procedure, can be utilized. From 8/1989 to 8/1993 we performed 8 MESA combined with IVF. From 9/1993 to 6/1994 we carried out 57 MESA and TESE procedures in combination with ICSI treating 46 patients. MESA was performed usin g an operating microscope; testicular sperm retrieval was carried out by open biopsy. The ICSI procedure was carried out using van Steirtegh em's technique. In the IVF group we observed no pregnancy, in the ICSI group (57 retrieval procedures in 46 patients) we observed fertilizat ion of at least one oocyte in 32 cases. Pregnancy occurred in 17 cases (one aborted). MESA is indispensable in the treatment of male inferti lity caused by non-operable obstruction of the seminal ducts. The valu e of MESA has been greatly enhanced by the development of ICSI. TESE i s quite unthinkable without ICSI.