Objective: This study aimed to evaluate reproductive outcomes according to the timing of testicular sperm retrieval. Methods: The study included 282 infertile couples divided into three groups: group A (freeze-thawed testicular sperm extraction [TESE] sperm, n=233), group B (fresh TESE sperm collected 1 day before ovum pickup, n=22), and group C (fresh TESE sperm collected on the same day as ovum pickup, n=27). The indications for TESE were surgically uncorrectable azoospermia or ejaculation failure, often accompanied by medical comorbidities such as diabetes mellitus and spinal cord injury. The outcome parameters assessed were fertilization rates, embryo quality, and clinical pregnancy rates. Results: The mean paternal age was 36.8±5.7 years, and the mean maternal age was 32.6±3.5 years. The mean duration of infertility was 2.9±1.8 years. The fertilization rates were 70.7%, 78.9%, and 73.0% for groups A, B, and C, respectively (p=0.047). The percentages of good-quality embryos were 68.2%, 65.3%, and 48.4%, respectively (p=0.007); specifically, the percentage of good-quality embryos was significantly lower in group C compared with the other two groups. Clinical pregnancy rates per transfer were similar at 51.1%, 50.0%, and 48.1% (p=0.958), with no differences observed in miscarriage rates. Conclusion Testicular sperm retrieval can be safely performed 1 day before ovum pickup, resulting in favorable fertility outcomes.

We report a 72-year-old man suffering from recurrent attacks of transient drowsy mentality during meal or on orthostatic body position. Markedly disturbed collateral blood flow to right hemisphere was observed on conventional cerebral angiography. Acute and old ischemic lesions in the right internal borderzone area were also noticed on magnetic resonance image. Postprandial and orthostatic hypotension in the present case could be the cause of the recurrent neurological deficit developed in the primarily disturbed collaterals in the right middle cerebral territory.
Aged ; Carotid Artery, Internal* ; Cerebral Angiography ; Humans ; Hypotension* ; Hypotension, Orthostatic ; Ischemic Attack, Transient* ; Meals