We studied the role of assisted fertilization (subzonal insemination, intracytoplasmic sperm injection) in enhancing fertilization and pregnancy rate in obstructive azoospermia.
MESA was performed in the patients with congenital absence of the vas deferens and unreconstructable obstructive azoospermia. Sperm were aspirated microsurgically from various sites along the epididymal stump. Sperm were then washed on a
mini-Percoll
gradient or swim-up method and treated by 2-deoxyadenosine and pentoxifylline.
Conventional IVF (group Ⅰ, 14 cycles), SUZI (group Ⅱ, 13 cycles) and ICSI (group Ⅲ, 28 cycles) were carried out in 55 treatment cycles.
@ES The clinical results are as follows:
@EN 1. Fertilization rates for group Ⅰ, Ⅱ and Ⅲ were 16.1%, 31.4% and 48.6%, retrospectively (p<0.05).
2. Clinical pregnancy rates for group Ⅰ, Ⅱ and Ⅲ were 7.1%, 7.7%, and 32.1%, retrospectively.
3. In 5 of MESA-ICSI cycles, epididymal sperm from alloplastic spermatocele were used and 2 clinical pregnancies (40%) were obtained.
According to our results the combined MESA-ICSI procedure is highly effcient in improving fertilization and pregnancy rate in congenital absence of the vas deferens and unreconstructable obstructive azoospermia.
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