Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection

A new effective approach to infertility as a result of congenital bilateral absence of the vas deferens

H. Tournaye, P. Devroey, J. Liu, P. Nagy, W. Lissens, A. Van Steirteghem

Research output: Contribution to journalArticle

294 Citations (Scopus)

Abstract

Objective: To present and assess the efficacy of a new approach for the treatment of infertility due to congenital bilateral absence of the vas deferens. Design: A retrospective study of consecutive trials. Setting: Centre for Reproductive Medicine, which is a tertiary referral institution. Patients: Twelve couples suffering from infertility because of congenital bilateral absence of the vas deferens. Interventions: A microsurgical epididymal sperm aspiration procedure was performed in the husbands, followed by intracytoplasmic sperm injection of oocytes recovered from the wives. Cleaving embryos were transferred to the uterine cavity 48 hours after the intracytoplasmic sperm injection procedure. Main Outcome Measures: Sperm parameters after microsurgical epididymal sperm aspiration, fertilization, cleavage, and pregnancy rates. Results: In all 14 microsurgical epididymal sperm aspiration procedures, sperm was retrieved. Notwithstanding the poor quality of this epididymal sperm, a fertilization rate of 58% was achieved after intracytoplasmic sperm injection. On 10 occasions, embryos were transferred and five patients became pregnant, i.e., an overall pregnancy rate of 35.7% per started trial and 50.0% per transfer. Another two patients became pregnant after replacement of frozen-thawed embryos, which increases the pregnancy rate to 50.0% per microsurgical epididymal sperm aspiration procedure. Early pregnancy wastage was 57%, limiting the ongoing pregnancy rate to 21.4% per microsurgical epididymal sperm aspiration procedure. Conclusion: This study shows the combined microsurgical epididymal sperm aspiration-intracytoplasmic sperm injection procedure to be highly efficient in achieving fertilization in vitro, even after recovery of grossly impaired epididymal sperm.

Original languageEnglish
Pages (from-to)1045-1051
Number of pages7
JournalFertility and Sterility
Volume61
Issue number6
Publication statusPublished - 1994

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Sperm Retrieval
Intracytoplasmic Sperm Injections
Infertility
Pregnancy Rate
Spermatozoa
Embryonic Structures
Spouses
Fertilization
Reproductive Medicine
Fertilization in Vitro
Oocytes
Congenital bilateral aplasia of vas deferens
Referral and Consultation
Retrospective Studies
Outcome Assessment (Health Care)
Pregnancy

Keywords

  • Azoospermia
  • congenital bilateral absence of vas deferens
  • epididymal sperm
  • intracytoplasmic sperm injection

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection : A new effective approach to infertility as a result of congenital bilateral absence of the vas deferens. / Tournaye, H.; Devroey, P.; Liu, J.; Nagy, P.; Lissens, W.; Van Steirteghem, A.

In: Fertility and Sterility, Vol. 61, No. 6, 1994, p. 1045-1051.

Research output: Contribution to journalArticle

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abstract = "Objective: To present and assess the efficacy of a new approach for the treatment of infertility due to congenital bilateral absence of the vas deferens. Design: A retrospective study of consecutive trials. Setting: Centre for Reproductive Medicine, which is a tertiary referral institution. Patients: Twelve couples suffering from infertility because of congenital bilateral absence of the vas deferens. Interventions: A microsurgical epididymal sperm aspiration procedure was performed in the husbands, followed by intracytoplasmic sperm injection of oocytes recovered from the wives. Cleaving embryos were transferred to the uterine cavity 48 hours after the intracytoplasmic sperm injection procedure. Main Outcome Measures: Sperm parameters after microsurgical epididymal sperm aspiration, fertilization, cleavage, and pregnancy rates. Results: In all 14 microsurgical epididymal sperm aspiration procedures, sperm was retrieved. Notwithstanding the poor quality of this epididymal sperm, a fertilization rate of 58{\%} was achieved after intracytoplasmic sperm injection. On 10 occasions, embryos were transferred and five patients became pregnant, i.e., an overall pregnancy rate of 35.7{\%} per started trial and 50.0{\%} per transfer. Another two patients became pregnant after replacement of frozen-thawed embryos, which increases the pregnancy rate to 50.0{\%} per microsurgical epididymal sperm aspiration procedure. Early pregnancy wastage was 57{\%}, limiting the ongoing pregnancy rate to 21.4{\%} per microsurgical epididymal sperm aspiration procedure. Conclusion: This study shows the combined microsurgical epididymal sperm aspiration-intracytoplasmic sperm injection procedure to be highly efficient in achieving fertilization in vitro, even after recovery of grossly impaired epididymal sperm.",
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AB - Objective: To present and assess the efficacy of a new approach for the treatment of infertility due to congenital bilateral absence of the vas deferens. Design: A retrospective study of consecutive trials. Setting: Centre for Reproductive Medicine, which is a tertiary referral institution. Patients: Twelve couples suffering from infertility because of congenital bilateral absence of the vas deferens. Interventions: A microsurgical epididymal sperm aspiration procedure was performed in the husbands, followed by intracytoplasmic sperm injection of oocytes recovered from the wives. Cleaving embryos were transferred to the uterine cavity 48 hours after the intracytoplasmic sperm injection procedure. Main Outcome Measures: Sperm parameters after microsurgical epididymal sperm aspiration, fertilization, cleavage, and pregnancy rates. Results: In all 14 microsurgical epididymal sperm aspiration procedures, sperm was retrieved. Notwithstanding the poor quality of this epididymal sperm, a fertilization rate of 58% was achieved after intracytoplasmic sperm injection. On 10 occasions, embryos were transferred and five patients became pregnant, i.e., an overall pregnancy rate of 35.7% per started trial and 50.0% per transfer. Another two patients became pregnant after replacement of frozen-thawed embryos, which increases the pregnancy rate to 50.0% per microsurgical epididymal sperm aspiration procedure. Early pregnancy wastage was 57%, limiting the ongoing pregnancy rate to 21.4% per microsurgical epididymal sperm aspiration procedure. Conclusion: This study shows the combined microsurgical epididymal sperm aspiration-intracytoplasmic sperm injection procedure to be highly efficient in achieving fertilization in vitro, even after recovery of grossly impaired epididymal sperm.

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