THE MINI-MICRO-EPIDIDYMAL SPERM ASPIRATION FOR SPERM RETRIEVAL - A STUDY OF UROLOGICAL OUTCOMES

Epididymal sperm aspiration and in-vitro fertilization (IVF) with intr acytoplasmic sperm injection is an established treatment for obstructi ve azoospermia. Sperm aspiration is performed with either an incision or percutaneously, To control costs, minimize morbidity and retain the advantages of both approaches, we developed a mini-incision technique for epididymal aspiration and here report sperm retrieval and procedu re-related outcomes. Twenty-six consecutive patients with obstructive azoospermia underwent epididymal sperm retrieval through a 1 cm incisi on with local anaesthesia to provide spermatozoa for concurrent IVF cy cles. The quality of retrieved spermatozoa, the quantity of spermatozo a cryopreserved as well as anaesthetic requirement, recovery time and patient satisfaction were evaluated. Fresh epididymal spermatozoa were retrieved in 25 of 26 (96%) patients. In one patient, testicular sper m extraction was necessary. Excess motile spermatozoa were cryopreserv ed in 24 of 26 (92%) patients; a mean total motile count of 4.8 x 10(6 ) motile spermatozoa were banked. The procedure was performed with 62% of patients receiving minimal i.v. sedation. Post-procedure recovery was rapid, with a median time to return to work of 2.0 days with a med ian of 2.0 pain pills taken. Procedure-related satisfaction was high. The mini-micro-epididymal sperm aspiration achieves the goals of relia ble retrieval of abundant epididymal spermatozoa with a single, minima lly morbid procedure. It appears to combine the advantages of the inci sion and percutaneous approaches.