NATURAL SPERMATOCELES IN IRREVERSIBLE OBSTRUCTIVE AZOOSPERMIA - RESERVOIRS OF VIABLE SPERMATOZOA FOR ASSISTED CONCEPTION

Fine needle aspiration of asymptomatic spermatoceles detected in five men with obstructive azoospermia was evaluated as a minimally invasive method of sperm retrieval for assisted conception, Sperm preparations adequate for in-vitro fertilization were initially obtained from thre e men, but there was failure of fertilization in all three cycles, How ever, intracytoplasmic sperm injection (ICSI) in three couples resulte d in fertilization of 58% of metaphase II oocytes, with embryo transfe rs in five of six cycles, A successful pregnancy and delivery resulted from spermatozoa from a man with an irreversible vasectomy, for whom previous epididymal microaspiration and ICSI had been unsuccessful, Sp ermatoceles were found in 4% of men with irreversible obstructive azoo spermia referred for assisted conception. These patients should theref ore be examined very carefully for small cysts near the epididymis, be cause fine needle aspiration, usually without anaesthesia, can instant ly locate a ready source of viable spermatozoa for ICSI, This is less invasive than the alternative sperm retrieval procedures, which are mo re traumatic and require local or general anaesthesia.