TALAT YURDAKUL, HÜSEYİN GÖRKEMLİ, MURAD AKTAN, SELÇUK DUMAN, SELÇUK GÜVEN
Gynecology Obstetrics & Reproductive Medicine - 2005;11(1):40-44
Objective: It is usually possible to recover sperm in both obstructive and non-obstructive azoospermic patients by microsurgical epididymal aspiration (MESA) or testicular sperm extraction (TESE) and ICSI could be performed with these spermatozoas. Study Design: Ninty-one males were diagnosed as azoospermia in the Urology Department, when sperm was able to recovered, intracytoplasmic sperm injection (ICSI) treatment was applied in our Assisted Reproductive Technology (ART) unit during the period of November 2000 to April 2003. MESA was performed to 13 obstructive azoospermic (OA) males and TESE was performed to 78 non-obstructive azoospsermic (NOA) males. Results: Mature spermatozoa were picked up from all of the obstructive azoospermic patients. Mature spermatozoa were also picked up from 47 (60%) NOA patients. 92 ovulation induction cycles were carried out for ICSI. Of these cycles 29 were carried out with epididymal mature spermatozoa and 63 cycles carried out with testicular mature spermatozoa in non-obstructive azoospermics. In MESA group, fertilization rate was 149/243 (61%). Biochemical pregnancies were achieved in 6 couples (46%), a healthy twin was delivered in one couple (7.6%) and pregnancies of two couples are ongoing. In TESE group, fertilization rate was 181/488 (37.3%). Biochemical pregnancies were achieved in 13 couples (27%) and in 7 (14.8%) couples healthy delivery were done, one of them was twin. Conclusion: When sperm can be picked up by MESA or TESE from an azoospermic patient,IVF/ICSI is the only choice of treatment for these infertile couples.
