Initial experiences of a testicular sperm extraction programme for assisted reproduction in Ireland

Background The technique aspirating spermatozoa from the testis is a new de velopment in male infertility treatment. It is appropriate for infertile co uples where the male has azoospermia but is still producing live motile spe rmatazoa in the testes. Aim To describe the initial experiences of a testicular sperm extraction pr ogramme (TESE) coupled with intracytoplasmic sperm injection (ICSI) in 18 m en during 1998, Methods Spermatozoa were obtained by direct aspiration from the testes usin g a 16 gauge needle with cannula and negative suction under local anaesthet ic. All samples obtained were to be cryopreserved for use in a subsequent I CSI cycle. Results All five men with congenital bilateral absence of the vas deferens to be carriers of cystic fibrosis gene mutations. No gene deletions were fo und in their wives. No other cyto or molecular genetic abnormalities were o therwise found. Twenty one procedures were carried out. The mean number of aspirations was 1.72. Eleven samples from 10 men had sperm suitable for ICS I post-freeze. Post-procedure pain was the universal side-effect. Eight cou ples had a single attempt at ICSI, two couples two each. Fertilisation rate was 71.4%. Two pregnancies were achieved. Conclusion TESE may give hope in selected cases of azoospermia of fathering a child without the involvement of a third party.