In this cross-sectional retrospective study, 300 cycles of sperm retrieval from the epididymis and the testis on 213 patients for the intracytoplasmic sperm injection at the Infertility Department of Tu Du Hospital from March 2003 to May 2004 were examined. The results showed that: 100% cycles with embryos and the pregnancy rate of 47.9%; there is no complication except a mild scrotal discomfort lasting a few days after open surgery; percutaneous epididymal sperm aspiration (PESA) was the most performed retrieval technique (61%), which was easy-done, quickly-performed, safe and effective
Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Epididymis ; Testis

The first Viet Nam baby born from intracytoplasmic sperm injection using testicular sperm from impaired spermatogenesis testes in 1/3/2004. There was approximately 50000 sperm after preparation, among them 20% was motile. From 12 retrieved oocytes, 11 were mature and therefore injected. Five oocytes fertilized and developed into 4 embryos. Embryo transfer was carried out for all 4 embryos. One embryo implanted and kept growing till the 37th week of pregnancy. Patient underwent ceasarian section
Spermatogenesis ; Sperm Retrieval ; Sperm Injections, Intracytoplasmic

We performed microscopic sperm aspiration and IVF in 2 cases of distal vas obstruction. 4 cases or epididymal obstruction, 3 cases of congenital vas aplasia. The results were as follows ; 1. The fertilization was successful in 2 cases of distal vas obstruction(100%). 1 case of epididymal obstruction(25%). 1 case of congenital vas. aplasia(33.3%). 2. In 4 cases with Sertoli cell failure. the count and quality of aspirated sperm was lower than in 5 cases with normal hormonal study. The fertilization was successful in 1 case with Sertoli cell failure(25%) and 3 cases with normal hormonal study(60%). In conclusion. microscopic sperm aspiration and IVF proved helpful in treatment of patients with distal vas obstructin, congenital vas aplasia. but the vasoepididymostomy proved more helpful in treatment of patients with epididymal obstruction then microscopic sperm aspiration and IVF until now. When microscopic sperm aspiration and IVF is performed, it seems that in Sertoli cell failure group. there will be lesser fertilization success cases than in normal hormonal study group.
Azoospermia* ; Fertilization ; Fertilization in Vitro* ; Humans ; Sperm Retrieval* ; Spermatozoa*

OBJECTIVETo investigate the value and clinical application of the Three-Step Sperm Retrieval method in improving the sperm retrieval rate for non-obstructive azoospermia (NOA) patients.

METHODSSeventy-three NOA patients underwent Three-Step Sperm Retrieval in the following order of procedures: testicular fine needle aspiration (TFNA), testicular sperm extraction (TSE), and microdissection testicular sperm extraction (MD-TSE). The testicular tissue obtained from each step was observed for spermatozoa under the 400-fold inverted microscope. If spermatozoa were found in one step, the operation would be stopped; otherwise, the next step would be carried out. The testicular tissue was subjected to pathological examination.

RESULTSSpermatozoa was found in the testicular tissue in 38.4% of the cases (28/73) at TFNA as the first step, in 52.1% (38/73) at TFNA and TSE, and in 64.4% (47/73) at TFNA, TSE and MD-TSE. Pathological examination showed 25 of the cases to be Sertoli cell-only syndrome, 21 to be sperm maturation arrest and the other 27 to be hypospermatogenesis, in which spermatozoa were found in 10, 14 and 23 cases, respectively.

CONCLUSIONThe Three-Step Sperm Retrieval method can significantly improve the sperm retrieval rate for NOA patients. And the sperm retrieval rate is associated with the pathological type of the testicular tissue, a higher rate with hypospermatogenesis.

Adult ; Azoospermia ; Humans ; Male ; Sperm Retrieval ; Testis ; pathology ; surgery

A 31 year old Filipino male diagnosed with obstructive azoospermia underwent TESE. Other current advanced sperm retrieval techniques include MESA, PESA and TESA confounded with female factors such as advanced maternal age and polycystic ovaries, IVF-ICSI eventually resulted to a successful pregnacy outcome. Several factors contributing to the success of IVF-ICSI eventually resulted to a successful pregnancy outcome. Several factors contributing to the success of IVF-ICSI in this case were also discussed. Although assisted reproductive technology is relatively new in our country, it proved to be promising in our local setting.
Human ; Female ; Adult ; REPRODUCTIVE TECHNIQUES, ASSISTED ; AZOOSPERMIA ; SPERM RETRIEVAL

No abstract available.
Blastocyst ; Coculture Techniques ; Fertilization ; Oocytes* ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval* ; Spermatozoa*

OBJECTIVE: This study was carried out to compare the clinical outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia according to sperm retrieval site and technique; microsurgical epididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), testicular sperm extraction by open biopsy (TESE). METHODS: The outcomes of ICSI and IVF-ET were evaluated and compared among 3 groups. Seventy three men suffering from infertility due to obstructive azoospermia had 107 ICSI cycles using MESA (21 cycles in 15 patients), PESA (26 cycles in 17 patients) and TESE (60 cycles in 41 patients). RESULTS: In the clinical outcomes in patients undergoing ICSI with epididymal or testicular sperm, there were no significant differences in fertilization rate (66.1% vs. 60.5%), cleavage rate (94.9% vs. 97.6%), cumulative embryo score (CES) (51.3 vs. 58.8), implantation rate (7.9% vs. 6.1), and clinical pregnancy rate per ET (30.4% (14/46) vs. 25.4% (15/59)) between both groups. Also, in the clinical outcomes in ICSI patients using MESA, PESA, TESE, there were no significant differences in fertilization rate (61.8%, 69.4%, 60.5%), cleavage rate (92.1%, 97.3%, 97.6%), CES (38.1, 52.0, 58.8), implantation rate (9.5%, 6.6%, 6.1%), and clinical pregnancy rate per ET (35% (7/20), 26.9% (7/26), 25.4% (15/59)) among 3 groups. CONCLUSION: When compared with MESA or TESE, PESA, the clinical outcomes were similar in ICSI patients with obstructive azoospermia whatever the origin or the technique of sperm retrieval. However, we considered PESA is more time-saving and cost effective for ICSI in patients with obstructive azoospermia.
Azoospermia ; Biopsy ; Embryonic Structures ; Fertilization ; Humans ; Infertility ; Male ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic* ; Sperm Retrieval ; Spermatozoa*

OBJECTIVE: This study was carried out to compare the clinical outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia according to sperm retrieval site and technique; microsurgical epididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), testicular sperm extraction by open biopsy (TESE). METHODS: The outcomes of ICSI and IVF-ET were evaluated and compared among 3 groups. Seventy three men suffering from infertility due to obstructive azoospermia had 107 ICSI cycles using MESA (21 cycles in 15 patients), PESA (26 cycles in 17 patients) and TESE (60 cycles in 41 patients). RESULTS: In the clinical outcomes in patients undergoing ICSI with epididymal or testicular sperm, there were no significant differences in fertilization rate (66.1% vs. 60.5%), cleavage rate (94.9% vs. 97.6%), cumulative embryo score (CES) (51.3 vs. 58.8), implantation rate (7.9% vs. 6.1), and clinical pregnancy rate per ET (30.4% (14/46) vs. 25.4% (15/59)) between both groups. Also, in the clinical outcomes in ICSI patients using MESA, PESA, TESE, there were no significant differences in fertilization rate (61.8%, 69.4%, 60.5%), cleavage rate (92.1%, 97.3%, 97.6%), CES (38.1, 52.0, 58.8), implantation rate (9.5%, 6.6%, 6.1%), and clinical pregnancy rate per ET (35% (7/20), 26.9% (7/26), 25.4% (15/59)) among 3 groups. CONCLUSION: When compared with MESA or TESE, PESA, the clinical outcomes were similar in ICSI patients with obstructive azoospermia whatever the origin or the technique of sperm retrieval. However, we considered PESA is more time-saving and cost effective for ICSI in patients with obstructive azoospermia.
Azoospermia ; Biopsy ; Embryonic Structures ; Fertilization ; Humans ; Infertility ; Male ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic* ; Sperm Retrieval ; Spermatozoa*

OBJECTIVETo analyze the clinical outcomes of intracytoplasmic sperm injection (ICSI) with spermatozoa from different sources.

METHODSWe retrospectively studied the rates of fertilization, clinical pregnancy, implantation, abortion, ectopic pregnancy and delivery in 682 patients treated by ICSI, who were divided according to the sperm sources into an ejaculated sperm group (ES, n = 598), a percutaneous epididymal sperm aspiration (PESA, n = 58) and a testicular sperm extraction (TSE, n = 26).

RESULTSThe fertilization rate was significantly lower in the TSE than in the ES and PESA groups (81.06% vs 87.95% and 87.82%, P < 0.05). But no statistically significant differences were observed among the ES, PESA and TSE groups in the rates of clinical pregnancy (39.46%, 48.28% and 34.62%), implantation (19.80%, 23.80% and 18.34%), abortion (13.13%, 17.86% and 11.11%), ectopic pregnancy (5.51%, 7.14% and 11.11%) and delivery (32.11%, 36.21% and 26.92%) (P > 0.05).

CONCLUSIONAlthough TSE-obtained sperm affect the rate of fertilization, those obtained by TSE and PESA do not obviously influence the outcome of clinical pregnancy.

Adult ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; methods ; Sperm Retrieval ; Spermatozoa

OBJECTIVETo evaluate histopathologic examination of the testis tissue from testicular sperm aspiration (TESA).

METHODSWe analyzed the results of inverted microscopy and histopathologic examination of 96 samples of testis tissue from TESA, and compared the accuracy of the two methods in detecting sperm in the testis tissue.

RESULTSAmong the 11 cases in which sperm was found by inverted microscopy, 9 were confirmed by histopathologic examination, and among the 57 cases in which sperm was not detected by inverted microscopy, 11 (19.3%) were found with sperm by histopathologic examination. Histopathologically, the cases in which sperm was not found by inverted microscopy included Sertoli-cell-only syndrome (n = 34), maturation arrest (n = 12) and hypospermatogenesis (n = 11).

CONCLUSIONHistopathologic examination may reveal sperm in the TESA testis tissue proved to be sperm-absent by microscopy, and thus offer valuable information for a second testicular sperm retrieval.

Adult ; Azoospermia ; pathology ; Humans ; Male ; Middle Aged ; Sperm Count ; Sperm Retrieval ; Testis ; pathology ; Young Adult