Apparent fertility of human spermatozoa from the caput epididymidis.
Fifty-one patients with obstructive azoospermia caused by blockage at the caput epididymidis have been followed for 4 years after undergoing "specific tubule" vasoepididymostomy, bypassing the corpus and cauda. The patency rate was 73%, and the pregnancy rate was 31%. There was no correlation between sperm count and pregnancy rate, but there was a strong correlation with sperm motility. With less than 20% motility, only 15% of the patients became pregnant, but with greater than 20% motility postoperatively, 58% became pregnant. If the wife was over 30 years old, only 21% got pregnant. If the wife was under 30, 67% got pregnant. "Redo" cases were just as likely to succeed as "first-time" attempts. In the "patent" cases, 43% of patients with spermatozoa that never reached or traversed the corpus or cauda epididymidis produced a pregnancy. Spermatozoa from the proximal caput produced a 33% pregnancy rate, whereas spermatozoa from the distal caput produced a 50% pregnancy rate. One-half of the pregnancies occurred more than 2 years postoperatively.
Silber
S J
SJ
St. Luke's Hospital West, St. John's Mercy Medical Center, St. Louis, Missouri 63017.
D004822:Epididymis / Q000166:cytology / Q000502:physiology* / Q000601:surgery; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000473:pathology / Q000503:physiopathology; D008297:Male; D009845:Oligospermia / Q000473:pathology / Q000503:physiopathology; D013081:Sperm Motility; D013094:Spermatozoa / Q000166:cytology / Q000502:physiology*; D014659:Vasectomy / Q000379:methods