Reproductive Potential of Men with Obstructive Azoospermia Undergoing Percutaneous Sperm Retrieval and Intracytoplasmic Sperm Injection According to the Cause of Obstruction

Abstract

Percutaneous sperm retrieval is an effective method to retrieve sperm in men with obstructive azoospermia irrespective of the cause of obstruction. The chance of achieving a live birth and the profile of neonates born after sperm injection do not seem to be related to the cause of obstruction.

Relationship of paternal age with outcome of percutaneous epididymal sperm aspiration–intracytoplasmic sperm injection, in cases of congenital bilateral absence of the vas deferens

“…Meng et al (21) and Aydos et al (22) reported impaired spermatogenesis in some men with CBAVD; animal experiments showed a higher impairment of spermatogenesis with obstruction before maturation of the gonads, compared with obstruction as an adult. In contrast, others demonstrated no effect of the interval since vasectomy on the ICSI outcome in men with obstructive azoospermia after vasectomy (2,(23)(24)(25)(26). This discrepancy could be related to the fact that the etiology of obstruction differs in men who have had a vasectomy, compared with those who have CBAVD.…”

“…It is classified into obstructive azoospermia, which is caused by congenital or acquired obstruction, and nonobstructive azoospermia, which is caused by testicular failure (1,2). Azoospermia does not necessarily imply sterility, because many azoospermic men still maintain sperm production at varying levels within their testes (3,4).…”

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

“…21 In our series, TESE was done in 33% patients as a rescue procedure after failed PESA whereas, Esteves et al had to revert to rescue procedure in only 17% cases. 22 No difference in fertilization rates was found between the ICSI attempts performed with ejaculated and surgically retrieved spermatozoa in infertile men. There was also no difference in pregnancy outcome between two groups, which is in consensus with many studies.…”

“…There was also no difference in pregnancy outcome between two groups, which is in consensus with many studies. 22,23 However, some studies have found lower outcome of ICSI with surgically retrieved sperm vis ejaculated sperms. 24 In our patients, results of ICSI cycles using epididymal and testicular sperm had similar outcomes showing that source of sperm or etiology does not affect sperm injection outcome as also shown in other studies.…”

“…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.…”