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The Role of Microsurgical Reconstruction in the Era of ICSI

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Microsurgery for Fertility Specialists

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Abstract

Even in the era of advanced assisted reproductive techniques, microsurgical reconstruction is an important and relevant treatment for obstructive azoospermia. Microsurgical reconstruction provides couples the opportunity to create a spontaneous pregnancy and thereby avoiding the expense, limitations, and risks of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). The apparent ease of advanced assisted reproductive techniques should not overshadow the fact that the expense and risks of IVF/ICSI may be unjustifiable. Sperm retrieval relegates couples to IVF/ICSI and subjects fertile female partners and the offspring to potentially avoidable risk. Approximately 30% cycles in 2009 resulted in twin or higher gestation and these pregnancies are associated with higher rates of prematurity, low birth weight, and severe neonatal medical conditions [1]. Ovarian hyperstimulation syndrome is a potentially life-threatening complication of in vitro fertilization and moderate and severe ovarian hyperstimulation syndrome are estimated to occur in 3–6% and 0.1–2% of IVF cycles, respectively [2]. Every surgeon will encounter couples for whom the best option for pregnancy is sperm retrieval paired IVF/ICSI. For couples with amenable conditions, however the safety of a natural conception remains a compelling justification for microsurgical reconstruction.

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Authors and Affiliations

  1. Center for Male Fertility, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Karen Baker M.D. & Edmund Sabanegh Jr M.D.

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  1. Karen Baker M.D.
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  2. Edmund Sabanegh Jr M.D.
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Correspondence to Karen Baker M.D. .

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Editors and Affiliations

  1. Medical College of Wisconsin, Department of Urology, W. Wisconsin Ave 9200, Milwaukee, 53226, Wisconsin, USA

    Jay I. Sandlow

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Baker, K., Sabanegh, E. (2013). The Role of Microsurgical Reconstruction in the Era of ICSI. In: Sandlow, J. (eds) Microsurgery for Fertility Specialists. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4196-0_11

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  • DOI: https://doi.org/10.1007/978-1-4614-4196-0_11

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