SUCCESSFUL IN-VITRO FERTILIZATION AND PREGNANCY BY MICROMANIPULATION WITH EPIDIDYMAL SPERM

Purpose: To examine the effectiveness of micromanipulation on the trea tment of the patients with obstructive azoospermia, subzonal inseminat ion or partial zona dissection was performed using epididymal sperm of the 23 patients, and the in vitro fertilization and embryo transfer ( IVF-ET) outcomes were analyzed. Results: Fertilized oocytes were obtai ned in II cycles of the 25 treated cycles, and six pregnancies were es tablished by the subsequent ET. Through the analysis of 13 cycles in w hich both the micromanipulation and usual IVF insemination were perfor med, the fertilization rate per oocyte with the micromanipulation [25% (28/113)] was significantly higher than that with the usual inseminat ion method[4% (4/102)]. The micromanipulation was most useful for the treatment of the patients with congenital absence of the vas deferens. Moreover, there was no need to aspirate a large volume of the epididy mal fluid, but it was essential to prepare more than 10 mature oocytes retrieved. Conclusions: These results indicate that micromanipulation with epididymal sperm is an effective treatment for obstructive azoos permia, and careful preparations of sperm and well-controlled ovarian hyperstimulation are necessary for successful IVF-ET.