Feasibility and safety of microsurgical anastomosis for obstructive azoospermia patients with prior ICSI failure (20 cases)
10.3760/cma.j.cn101441-20220803-00330
- VernacularTitle:梗阻性无精子症患者ICSI助孕失败后精道显微重建术可行性与安全性分析——附20例报道
- Author:
Jianjun DONG
1
;
Jingpeng ZHAO
;
Chao YANG
;
Chencheng YAO
;
Ruhui TIAN
;
Erlei ZHI
;
Jianxiong ZHANG
;
Zheng LI
;
Peng LI
Author Information
1. 上海交通大学医学院附属第一人民医院泌尿外科临床医学中心男科，男性健康评估中心，上海 200080
- Publication Type:Journal Article
- Keywords:
Infertility, male;
Sperm injections, intracytoplasmic;
Obstructive azoospermia;
Microsurgical anastomosis
- From:
Chinese Journal of Reproduction and Contraception
2022;42(10):1003-1007
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the feasibility and safety of microsurgical anastomosis for obstructive azoospermia (OA) patients with prior intracytoplasmic sperm injection (ICSI) failure.Methods:From September 2015 to May 2020, the data of 20 OA patients with previous ICSI-assisted pregnancy failure admitted to the Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The characteristics of seminal tract microsurgical reconstruction were summarized, and the postoperative recurrence rate and clinical pregnancy rate were calculated.Results:Vasal obstruction was found in 8 patients and epididymal obstruction in 12 patients during microscopically reconstructed seminal tract. Among the patients with vasal obstruction, 1 patient developed OA after trauma and underwent laparoscopic-assisted right vasovasostomy (VV). Totally 7 patients developed OA after juvenile bilateral hernia, among whom 6 patients underwent further laparoscopic-assisted VV and 1 patient underwent vasovasostomy and epididymal cross anastomosis. Of the 8 patients who underwent VV, 6 achieved postoperative patency, and 2 couples achieved natural pregnancy. Patients with epididymal obstruction underwent microscopic vasoepididymostomy (VE), and 6 out of 12 patients achieved postoperative pregnancy, while 3 couples achieved natural pregnancy. No significant complications occurred in all patients during and after operation.Conclusion:Microsurgical anastomosis is an effective remedy for patients with OA after ICSI pregnancy failure, which can help patients achieve natural pregnancy.
