Sperm retrieval and fertilization in repeated percutaneous epididymal sperm aspiration

Percutaneous epididymal sperm aspiration (PESA) for retrieval of spermatozo a for intracytoplasmic sperm injection (ICSI) is a new simplified technique in the treatment of men with obstructive azoospermia, There has been a fea r that the PESA procedure, being blind, could cause damage to the epididyma l duct system and make it impossible to retrieve spermatozoa if a repeated procedure is required. We report here on repeated PESA procedures from the same unilateral epididymis, Twenty-seven men with obstructive azoospermia w ere investigated retrospectively regarding sufficiency of the number of mot ile spermatozoa for ICSI, fertilization rate (FR) and possibility of collec ting spermatozoa for cryopreservation in repeated RESA procedures. Sufficie nt motile spermatozoa for ICSI were found in a similar proportion of men at the first two attempts: 91 and 89% respectively. Fertilization rate and th e possibility of collecting spermatozoa for cryopreservation were also simi lar at the first two PESA procedures: 62 versus 67% and 33 versus 33% respe ctively. At the third procedure, motile spermatozoa for ICSI were retrieved in 86% (6/7), FR was 47% and spermatozoa were cryopreserved in one case. T wo men underwent a fourth PESA, In both cases, a sufficient number of motil e spermatozoa for ICSI was found and FR was 62%, This study shows that in m en with obstructive azoospermia, PESA can be repeated on the same unilatera l epididymis up to three times, with good opportunity of retrieving suffici ent motile spermatozoa for ICSI.