ANDROLOGICAL WORK-UP OF PATIENTS UNDERGOING MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION OR TESTICULAR SPERM EXTRACTION

Microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) require close cooperation between andrologists, urol ogists and gynaecologists. Intracytoplasmic sperm injections were esta blished in Giessen in March 1994 and embryo transfer (ET) was performe d in 342 of 375 patients (91.2%). The percentage of pregnancies and on going pregnancies are 35.4% per ET (32.3% per cycle) and 25.1% per ET (22.9% per cycle), respectively. Microsurgical procedures such as epid idymovasostomy or vasovasostomy and cryopreservation of human semen ar e also established methods. The purpose of the present study was to de scribe the andrological work-up for patients before MESA and TESE. Exp eriments demonstrate that incubation of testicular tissue samples in I VF medium and treatment with 1 mg ml(-1) pentoxifylline increase the n umber of extracted motile spermatozoa. Centrifugation of the medium re sults in a further concentration of sperm cells. If no motile spermato zoa can be found in the supernatant medium, they may be extracted dire ctly from the testicular tissue samples by means of a micromanipulator .