Thirty-three azoospermic men were considered candidates for ART (Assisted Reproductive Technology), using sperm obtained from the epididymis because of bilateral congenital absence of the vas deferens (24 cases), bilateral obstructive azoospermia (8 cases) and unilateral hypoplasia of vas with the other side blockage (1 case). Sperm was successfully retrieved in 34 (94.44%) of the 36 occasions. According to our results, it was remarkable that the functional character of epididymal sperm was poor in average. In comparison with the normal standard, the total sperm density (7.5 x 106 ± 12 x 106 in average) and motility (20% ± 28% in average) after processing was lower. Moreover, the average motility index of epididymal sperm obtained by aspiration was prominently lower than that of normal control within 48 hours of sperm incubation. Poor viability might be the most significant character of the aspirated epididymal sperm. Besides of varying degrees of contamination with red blood cells, debris and macrophages, we found that 15 of 36 epididymal sperm samples (52%) in our series had detectable positive SpermMar test or microscopic sperm to sperm agglutination. We carried out oocyte retrieval in 33 females, 29 of them (88%) had 2 to 15 eggs obtained. The mean number of eggs obtained was 8, whereas the mean number of embryos transferred was 2 in 15 patients following insemination. Fertilization rate per oocyte was 15%, which is very low when compared to the usual fertilization rate routinely performed with normal ejaculated sperm in our laboratory. Only one pregnancy occurred in our series. During functional evaluation of the epididymal sperm, the only evidence in this study to predict higher fertilization rate is when the survivability of the sperm is longer after CO2 incubation. No matter how dense is the epididymal sperm aspirated, the fertilization rate could be as high as 82% only if there had more than 10% very motile sperm existed after six hours incubation.
|Number of pages||10|
|Publication status||Published - 1994|
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