Av. Hirsh et al., NATURAL SPERMATOCELES IN IRREVERSIBLE OBSTRUCTIVE AZOOSPERMIA - RESERVOIRS OF VIABLE SPERMATOZOA FOR ASSISTED CONCEPTION, Human reproduction, 11(9), 1996, pp. 1919-1922
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.