In a patient with a diagnosis of congenital vas deferens agenesis we d
ecided to carry out a microsurgical epididymal sperm aspiration in ord
er to attempt an in vitro fertilization (IVF). Since during scrotal ex
ploration no epididymus was found (probably as a consequence of a prev
ious surgical biopsy) a testicle biopsy was performed. The latter yiel
ded a few hundred sperms which were injected within the cytoplasm of h
is wife's oocytes (ICSI technique). Of the 18 oocytes, 3 were harmed d
uring the procedure and 16 hours later signs of normal fertilization w
ere detected in 6 of them, followed by the development of 4 embryos. T
hese were transcervically transferred to the uterus, 3 in 8 cell stage
and 1 in 6 cell stage; previously a 20 micron hole had been made with
acid Tyrode solution in the pelucida zone of each embryo. Fifteen day
s later, the result of the HCG, beta subunit assay was positive and a
month later a single 19 mm normal embryo was detected by ultrasound ec
hography.