Abstract
Microscopic epididymal sperm aspiration (MESA) for sperm retrieval and intracytoplasmic sperm injection (ICSI) is currently our routine treatment for selected male patients with obstructive azoospermia. In order to refine the surgical technique and obtain better quality sperm for our assisted reproductive technology program, we observed the epididymal tubules in 40 sessions of surgical exploration of the epididymis for sperm aspiration. Epididymal tubules with long-term obstruction could be divided into three groups on the basis of clinical observations and pathology findings: markedly dilated, mildly dilated, and nondilated. All of the markedly dilated epididymal tubules (grade III, n = 10) were azoospermic and ICSI could not be done. Epididymal sperm obtained from the mildly dilated tubules (grade II, n = 9) resulted in poorer fertilization (49%) and pregnancy (33%) rates than sperm obtained from nondilated epididymal tubules (grade I, n = 21, fertilization rate 72%, pregnancy rate 57%). These findings demonstrate that nondilated epididymal tubules are best for sperm retrieval and successful ICSI. We believe this observation will be a good surgical parameter for urologic surgeons performing MESA.
| Original language | English |
|---|---|
| Pages (from-to) | 838-844 |
| Number of pages | 7 |
| Journal | Journal of the Formosan Medical Association = Taiwan yi zhi |
| Volume | 97 |
| Issue number | 12 |
| Publication status | Published - Dec 1998 |
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Keywords
- Aspiration
- Intracytoplasmic sperm injection
- Male infertility
- Microscopic epididymal sperm
- Obstructive azoospermia
- Testicular sperm extraction
ASJC Scopus subject areas
- Medicine(all)
Cite this
Surgical and pathologic observations of epididymal tubules during microscopic epididymal sperm aspiration for intracytoplasmic sperm injection. / Chiang, Han-Sun; Liu, Chi Hong; Tzeng, Chii Ruey; Fang, Chia Lang.
In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 97, No. 12, 12.1998, p. 838-844.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical and pathologic observations of epididymal tubules during microscopic epididymal sperm aspiration for intracytoplasmic sperm injection
AU - Chiang, Han-Sun
AU - Liu, Chi Hong
AU - Tzeng, Chii Ruey
AU - Fang, Chia Lang
PY - 1998/12
Y1 - 1998/12
N2 - Microscopic epididymal sperm aspiration (MESA) for sperm retrieval and intracytoplasmic sperm injection (ICSI) is currently our routine treatment for selected male patients with obstructive azoospermia. In order to refine the surgical technique and obtain better quality sperm for our assisted reproductive technology program, we observed the epididymal tubules in 40 sessions of surgical exploration of the epididymis for sperm aspiration. Epididymal tubules with long-term obstruction could be divided into three groups on the basis of clinical observations and pathology findings: markedly dilated, mildly dilated, and nondilated. All of the markedly dilated epididymal tubules (grade III, n = 10) were azoospermic and ICSI could not be done. Epididymal sperm obtained from the mildly dilated tubules (grade II, n = 9) resulted in poorer fertilization (49%) and pregnancy (33%) rates than sperm obtained from nondilated epididymal tubules (grade I, n = 21, fertilization rate 72%, pregnancy rate 57%). These findings demonstrate that nondilated epididymal tubules are best for sperm retrieval and successful ICSI. We believe this observation will be a good surgical parameter for urologic surgeons performing MESA.
AB - Microscopic epididymal sperm aspiration (MESA) for sperm retrieval and intracytoplasmic sperm injection (ICSI) is currently our routine treatment for selected male patients with obstructive azoospermia. In order to refine the surgical technique and obtain better quality sperm for our assisted reproductive technology program, we observed the epididymal tubules in 40 sessions of surgical exploration of the epididymis for sperm aspiration. Epididymal tubules with long-term obstruction could be divided into three groups on the basis of clinical observations and pathology findings: markedly dilated, mildly dilated, and nondilated. All of the markedly dilated epididymal tubules (grade III, n = 10) were azoospermic and ICSI could not be done. Epididymal sperm obtained from the mildly dilated tubules (grade II, n = 9) resulted in poorer fertilization (49%) and pregnancy (33%) rates than sperm obtained from nondilated epididymal tubules (grade I, n = 21, fertilization rate 72%, pregnancy rate 57%). These findings demonstrate that nondilated epididymal tubules are best for sperm retrieval and successful ICSI. We believe this observation will be a good surgical parameter for urologic surgeons performing MESA.
KW - Aspiration
KW - Intracytoplasmic sperm injection
KW - Male infertility
KW - Microscopic epididymal sperm
KW - Obstructive azoospermia
KW - Testicular sperm extraction
UR - http://www.scopus.com/inward/record.url?scp=0032413173&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032413173&partnerID=8YFLogxK
M3 - Article
VL - 97
SP - 838
EP - 844
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
SN - 0929-6646
IS - 12
ER -