EPIDIDYMAL SPERM RETRIEVAL BY EPIDIDYMAL MICROPUNCTURE COMBINED WITH INTRACYTOPLASMIC SPERM INJECTION - DIFFERENCE BETWEEN ACQUIRED AND CONGENITAL IRREPARABLE OBSTRUCTIVE AZOOSPERMIA

To evaluate the differences in fertilization and pregnancy rates follo wing intracytoplasmic sperm injection (ICSI) of retrieved epididymal s perm between congenital (group 1) and acquired (group 2) unreconstruct able obstructive azoospermic patients, we compared the outcome of the ICSI procedure between these two groups. Thirty-six patients with obst ructive azoospermia received epididymal sperm retrieval by the micropu ncture method for the ICSI procedure. Main parameters evaluated were e pididymal fluid volume, sperm concentration, sperm motility, fertiliza tion rate and clinical pregnancy rate. There were no significant diffe rences in epididymal fluid and sperm concentration between the two gro ups. However, the sperm motility in group 1 was significantly higher t han that in group 2. The fertilization rates per couple in groups 1 an d 2 were 78.2 and 82% (nonsignificant). The pregnancy rate per couple in group 1 was 37.5% (6/16), while that in group 2 was only 5% (1/20); this difference was statistically significant (p < 0.05). Using epidi dymal sperm for the ICSI procedure, the chances of pregnancy for coupl es with congenital absence of the vas deferens were significantly high er compared with couples with acquired unreconstructable obstructive m ale infertility.