Human Reproduction, Vol 12, 1222-1226, Copyright © 1997 by Oxford University Press
R Ron-El, D Strassburger, S Friedler, D Komarovski, O Bern, Y Soffer and A Raziel
Testicular sperm retrieval for the treatment of non-obstructive azoospermia
requires the execution of an invasive procedure, with all its possible
attending complications and subsequent long-term effects. This study
suggests a new non-invasive approach for collection of spermatozoa in these
patients: the extended sperm preparation (ESP). ESP consists of conducting
a thorough microscopic search through many droplets of ejaculate sediment.
ESP was performed for 49 patients; in 17 patients (35%), spermatozoa were
found and subsequently used in intracytoplasmic sperm injection (ICSI). Of
these preparations, five yielded fewer motile spermatozoa than the number
of corresponding oocytes available, and in one patient only non-motile
spermatozoa were recovered. The remaining 32 ESP-negative patients
underwent testicular sperm extraction (TESE) from testicular biopsy.
Spermatozoa were found in 16 of 32 biopsies (50%) and subsequently used in
ICSI. Fertilization and cleavage rates were comparable in both ESP and TESE
groups, yielding four clinical pregnancies in each group (27 and 29%
respectively). Embryo morphology was defined as excellent in significantly
more cases in the ESP group than the TESE group, and implantation rate
appeared somewhat higher in the ESP group (16%) than the TESE group (13%).
The ESP technique yields results similar to TESE, and can be applied in
cases of non-obstructive azoospermia as a prerequisite modality enabling us
to avoid testicular biopsy in 35% of cases.
ARTICLES
Extended sperm preparation: an alternative to testicular sperm extraction in non-obstructive azoospermia
IVF and Infertility Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
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