Percutaneous epididymal sperm aspiration as a method for sperm retrieval in men with obstructive azoospermia seeking fertility: operative and laboratory aspects
Sandro C. Esteves 1
1 ANDROFERT - Andrology and Human Reproduction Clinic
Introduction: Congenital bilateral absence of vas deferens (CBAVD) is a non-treatable cause of obstructive azoospermia (OA). However, the affected men can father children by undergoing sperm retrieval (SR) and intracytoplasmic sperm injection (ICSI).
ARTICLE INFO Available at: www.brazjurol.com.br/videos/july_august_2015/Esteves_817_818video.htm
Sandro C. Esteves, MD, PhD
Andrology and Human Reproduction Clinic,
Av. Dr. Heitor Penteado 1464
Campinas, São Paulo 13075-460, Brazil
Sperm can be obtained by microepididymal sperm aspiration (MESA), percutaneous sperm aspiration (PESA), and testicular sperm extraction (TESE), from patients with congenital absence of the vas deferens (CBAVD). The authors of the video on PESA as a method for sperm retrieval in obstructive azoospermia nicely demonstrate this technique in men with CBAVD. These patients have an abnormal epididymis from this condition making the retrieval more challenging (1). In their case series of 32 men with CBAVD, success rate at obtaining motile sperm by PESA was 96.8%, with a live birth rate of 34.4% per attempt. The short-term outcome of resulting offspring was comparable with those obtained in other types of obstructive azoospermia. Percutaneous aspiration of sperm is an effective, safe, and reproducible means of obtaining adequate sperm in men who have obstructive azoospermia due to CBAVD.
1. Dohle GR, Ramos L, Pieters MH, Braat DD, Weber RF. Surgical sperm retrieval and intracytoplasmic sperm injection as treatment of obstructive azoospermia. Hum Reprod. 1998;13:620-3.
Tariq Hakki, MD