Microsurgical epididymal sperm aspiration: aspirate analysis and straws available after cryopreservation in patients with non-reconstructable obstructive azoospermia

Microsurgical epididymal sperm aspiration (MESA) combined with intracytopla smic sperm injection (ICSI) represents a great advance in the therapy of no n-reconstructable obstructive azoospermia. For procedure synchronization, a great number of organizational facilities are needed, Intentional cryopres ervation of the aspirate may reduce these problems, therefore the aim of th is study was to analyse the amount and quality of aspirate fluid obtained b y means of MESA and the quality of the vials after thawing, Furthermore, th e available cryopreserved straws were calculated. A total of 93 consecutive MESA procedures were performed and epididymal spermatozoa were obtained in 88 patients. Mean sperm concentration was 40.9 x 10(6) spermatozoa/ml. Glo bal and progressive motility were 24.8 and 7.5% respectively. In one-third of the aspirates, no progressive motile spermatozoa were found. The mean nu mber of straws available was 7.6. In 33 ICSI cycles with frozen-thawed epid idymal spermatozoa, a pregnancy rate of 42.4% was achieved. In conclusion, these data show that enough spermatozoa are available for various ICSI cycl es following a single MESA procedure in men with non-reconstructable obstru ctive azoospermia, Furthermore, ICSI with cryopreserved spermatozoa leads t o excellent pregnancy rates.