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Year : 2014  |  Volume : 6  |  Issue : 1  |  Page : 41-45

A single-center study examining the outcomes of percutaneous epididymal sperm aspiration in the treatment of obstructive azoospermia

1 Scott Department of Urology, Baylor College of Medicine, Houston, Texas, 77030, USA
2 McMaster Institute of Urology, St. Joseph's Hospital, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada

Correspondence Address:
Jason R Kovac
Scott Department of Urology, Baylor College of Medicine, Houston, Texas
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DOI: 10.4103/0974-7796.127026

PMID: 24669121

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Introduction: Obstructive azoospermia (OA) is characterized by normal spermatogenesis and the absence of sperm in the ejaculate. Variable success rates have been reported using in-vitro fertilization (IVF) combined with PESA in cases of men with OA. Aims: To determine fertilization and pregnancy outcomes from PESA-derived spermatozoa and to ascertain whether frozen spermatozoa yields similar outcomes compared to fresh specimens. Materials and Methods: The charts of 68 consecutive couples undergoing 68 cycles of sperm retrieval for OA over eight years (2002-2010) were retrospectively reviewed. Patients requiring testicular intervention were excluded ( n = 17). Results: Viable sperms were identified in 100% of men, and fresh spermatozoa were obtained in 40 patients (78.4%) simultaneously with female egg retrieval. The average fertilization rate was 77.7% with five embryos not surviving to transfer (12.5%). Pregnancies were confirmed in 48.6% (17/35). Twin gestations occurred in 11.8% (2/17) of cases. Frozen-thawed spermatozoa were used in 11 patients (21.6%). In this subgroup, the average fertilization rate was 73.6% with pregnancies confirmed in 54.5% (6/11). No multiple gestations were generated, and no complications occurred. The use of fresh spermatozoa for PESA provided no significant improvements in outcomes over frozen specimens. Summary: PESA is a very effective, simple, and safe method of obtaining spermatozoa for IVF. Outcomes obtained using fresh and frozen PESA-derived spermatozoa were similar and as such, either could be used during the IVF process.

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