Obstructive azoospermia: reconstructive techniques and results

Baker, Karen S.; Sabanegh, Edmund

doi:10.6061/clinics/2013(sup01)07

Cited by 50 publications

(85 citation statements)

References 63 publications

(85 reference statements)

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“…This confirms the epididymal function for spermatozoid maturation [44]. Overall patency is 50% and the pregnancy rate is around 35% [46][47][48].…”

supporting

confidence: 69%

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Vasectomy in Male Contraception and its Reversal

Wespes

2014

European Urology Supplements

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“…This confirms the epididymal function for spermatozoid maturation [44]. Overall patency is 50% and the pregnancy rate is around 35% [46][47][48].…”

supporting

confidence: 69%

“…However, the reported rates of vasal patency and pregnancy with this new and very expensive surgical technique are similar to that of microsurgical vasovasostomy. Given these results and the expense of robot-assisted surgery, the traditional microsurgical approach to vasal reconstruction is preferred [46,49].…”

mentioning

confidence: 99%

Vasectomy in Male Contraception and its Reversal

Wespes

2014

European Urology Supplements

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“…Treatment options in OA include microsurgical reconstruction and SR for ICSI 33. The SRR in OA is practically 100%, and are not influenced by the sperm collection method and cause of obstruction 934.…”

Section: Discussionmentioning

confidence: 99%

Comparison of sperm retrieval and reproductive outcome in azoospermic men with testicular failure and obstructive azoospermia treated for infertility

et al. 2014

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We assessed the rates of sperm retrieval and intracytoplasmic sperm injection outcomes, including the neonatal profile of infants conceived, in men with testicular failure. Three-hundred and sixty-five men with testicular failure who underwent micro-dissection testicular sperm extraction were included in this study. We compared their outcomes with 40 men with testicular failure who used donor sperm for injections due to failed retrieval, and 146 men with obstructive azoospermia who underwent percutaneous sperm retrieval. The retrieval rate in testicular failure was 41.4%, and the results were lower than the obstructed azoospermia (100%; adjusted odds ratio: 0.033; 95% CI: 0.007–0.164; P < 0.001). Live birth rates after sperm injections were lower in men with testicular failure (19.9%) compared with donor sperm (37.5%; adjusted OR: 0.377 (95% CI: 0.233–0.609, P < 0.001)) and obstructive azoospermia (34.2%; adjusted OR: 0.403 (95% CI: 0.241–0.676, P = 0.001). Newborn parameters of infants conceived were not significantly different among the groups. We concluded that the chances of obtaining sperm on retrieval and achieving a live birth after intracytoplasmic sperm injection (ICSI) are reduced in men with testicular failure. The profile of infants conceived after sperm injection does not seem to be negatively affected by testicular failure.

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“…In OA both reconstructive procedures and surgical retrieval are highly successful. [6][7][8] Non-Obstructive azoospermia (NOA) is associated with a spectrum of various severe and untreatable conditions associated with an intrinsic testicular impairment. 9 Parameters like history, physical examination, testicular volume and hormonal analysis (FSH, LH, TSH, Testosterone) and even the histology of a diagnostic biopsy are only indicative and not always predictive in diagnosing the cause of azoospermia because patients with maturation arrest (MA) generally have welldeveloped and normal-sized testes and normal hormonal levels.…”

Section: Introductionmentioning

confidence: 99%

Sperm recovery and IVF outcome after surgical sperm retrieval in azoospermia: our experience

Rai¹,

Rao²,

Prajwal³

2018

Int J Reprod Contracept Obstet Gynecol

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Background: In the last decade, male factor infertility has been recognized as a significant global problem, which is on an increase. Till date, very few options are available for ameliorating male factor infertility. Development of intracytoplasmic sperm injection has revolutionized the treatment of males with very low sperm counts or with poor quality sperm. However, patients with a diagnosis of azoospermia had no option but to resort to adoption or use of donor sperm. The clinical management of men with azoospermia seeking fertility has been a challenge for andrologists, urologists, and reproductive medicine specialists alike. The older approaches denied such couple the possibility of having own genetic children. Surgical sperm retrieval and intracytoplasmic sperm injection have successfully transformed the treatment of male infertility so that now most of the men can father their own children. The aim of this study is to present the outcome of IVF with surgically retrieved sperm from azoospermic men.Methods: This study was a retrospective analysis of 100 cycles using surgically retrieved sperm. Outcome measures were fertilization rate (FR) and implantation rate (IR) per transfer.Results: Sperm retrieval rate in our study was 76% when Per cutaneous epididymal sperm aspiration (PESA) and Testicular sperm extraction (TESE) are combined. Our data demonstrated similar outcome between the use of epididymal or testicular sperm in men with azoospermic. There was no statistical difference concerning fertilization rate, embryo quality and pregnancy rate between ICSI with surgically retrieved sperm and ejaculated sperms.Conclusions: Surgical sperm retrieval is a feasible and successful procedure. Spermatozoa can be retrieved from the testis in up to 76% of patients, even in cases with severe disorders of spermatogenesis and deranged hormonal profile. Comprehensive genetic counseling is important for infertile couples deciding for surgical sperm retrieval, since genetic disorders, as yet undetected, may be passed on to the following generation with multiplying variety.

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Obstructive azoospermia: reconstructive techniques and results

Cited by 50 publications

References 63 publications

Vasectomy in Male Contraception and its Reversal

Vasectomy in Male Contraception and its Reversal

Comparison of sperm retrieval and reproductive outcome in azoospermic men with testicular failure and obstructive azoospermia treated for infertility

Sperm recovery and IVF outcome after surgical sperm retrieval in azoospermia: our experience

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