Abstract
Purpose : To investigate sperm quality aspirated from the tubuli recti compared to that obtained from microsurgical epididymal sperm aspiration (MESA).
Methods : Sixteen patients with congenital bilateral absence of the vas deferens (CBAVD) underwent MESA. Six MESA procedures were difficult, and therefore sperm were retrieved from the tubuli recti ductules. Intraoperative sperm parameters, recovery after freeze–thaw, and ICSI outcomes were analyzed and compared between tubuli recti and MESA sperm.
Results : Mean initial sperm concentration was similar in both groups (18 vs. 16 million sperm/mL). Initial sperm motility was significantly higher in the tubuli recti group (35%) than the MESA group (25%). However, post thaw motility was higher with MESA compared to tubuli recti sperm (8.7 vs. 1.5%). ICSI fertilization rates after sperm freeze–thaw were 66% for tubuli recti sperm and 71% for MESA sperm.
Conclusions : Tubuli recti sperm may provide an attractive alternative to testis sperm extraction. Poor sperm recovery after freeze–thaw should be expected.
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references
Cha K-Y, Oum K-B, Kim H-J: Approaches for obtaining sperm in patients with male factor infertility. Fertil Steril 1997;67:985-995
Tournaye H: Surgical sperm recovery for intracytoplasmic sperm injection: Which method is to be preferred? Hum Reprod 1999;14(Suppl)1:71-81
Ubaldi F, Camus M, Tournaye H, Clasen K, Nagy E, Smitz J, Van Steirteghen A, Devroley P: Results of microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) in azoospermic men using intracytoplasmic sperm injection. Andrologia 1996;28(Suppl)1:71-75
Takihara H: The treatment of obstructive azoospermia in male infertility-Past, present, and future. Urology 1998;51(Suppl)5A:150-155
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;13:620-623
Nudell DM, Conaghan J, Pedersen RA, Givens CR, Schriock ED, Turek PJ: The mini-micro-epididymal sperm aspiration for sperm retrieval: A study of urological outcomes. Hum Reprod 1998;13:1260-1265
Bachtell N, Conaghan J, Turek PJ: The relative viability of human spermatozoa from the testis, epididymis and vas deferens before and after cryopreservation. Hum Reprod 1998;14:101-104
Schlegel PN, Berkeley AS, Goldstein M, Cohen J, Alikani M, Adler A, Gilbert BR, Rosenwaks Z: Epididymal micropuncture with in vitro fertilization and oocyte micromanipulation for the treatment of unreconstructable obstructive azoospermia. Fertil Steril 1994;61:895-900
WHO: WHO Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction. Cambridge, UK, Cambridge University Press, 1992.
Madadevan M, Trounson AO: Effect of cryoprotective media and dilution methods on the preservation of human spermatozoa. Andrologia 1983;15:355-366
Cayan S, Lee D, Conaghan J, Givens CA, Ryan IP, Schnock ED, Turek PJ: A comparison of intracytoplasmic sperm injection outcomes with fresh and cryopreserved epididymal sperm from the same couple. Hum Reprod 2001;16:495-499
Hovatta O, Moilanen J, von Smitten K, Reima I: Testicular needle biopsy, open biopsy, epididymal aspiration and intracytoplasmic sperm injection in obstructive azoospermia. Hum Reprod 1995;10:2595-2599
Schoysmann R, van Roosendaal E, Bollen N, Vandervorst M, Vanderzwalmen P, Standaert V, Berting G, Debauche C, Lefere C: Modern sperm retrieval techniques and their usefulness in oocyte fertilization. BJU International 2001;88:141-146
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Zenke, U., Jalalian, L., Shen, S. et al. The Difficult MESA: Findings from Tubuli Recti Sperm Aspiration. J Assist Reprod Genet 21, 31–35 (2004). https://doi.org/10.1023/B:JARG.0000025935.28895.30
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DOI: https://doi.org/10.1023/B:JARG.0000025935.28895.30