title: Successful in vitro fertilization and pregnancy by micromanipulation with epididymal sperm.
abstract: OBJECTIVE
  To examine the effectiveness of micromanipulation on the treatment of the patients with obstructive azoospermia, subzonal insemination or partial zona dissection was performed using epididymal sperm of the 23 patients, and the in vitro fertilization and embryo transfer (IVF-ET) outcomes were analyzed.
  
  
  RESULTS
  Fertilized oocytes were obtained in 11 cycles of the 25 treated cycles, and six pregnancies were established by the subsequent ET. Through the analysis of 13 cycles in which both the micromanipulation and usual IVF insemination were performed, the fertilization rate per oocyte with the micromanipulation [25% (28/113)] was significantly higher than that with the usual insemination method [4% (4/102)]. The micromanipulation was most useful for the treatment of the patients with congenital absence of the vas deferens. Moreover, there was no need to aspirate a large volume of the epididymal fluid, but it was essential to prepare more than 10 mature oocytes retrieved.
  
  
  CONCLUSIONS
  These results indicate that micromanipulation with epididymal sperm is an effective treatment for obstructive azoospermia, and careful preparations of sperm and well-controlled ovarian hyperstimulation are necessary for successful IVF-ET.
authors.affiliation: Department of Obstetrics and Gynecology, Branch Hospital, Nagoya University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Fukugaki
authors.forename: N
authors.initials: N
authors.lastname: Suganuma
authors.forename: T
authors.initials: T
authors.lastname: Kitagawa
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Hibi
authors.forename: K
authors.initials: K
authors.lastname: Miyake
authors.forename: Y
authors.initials: Y
authors.lastname: Tomoda
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D004624:Embryo Transfer / Q000592:standards; D004822:Epididymis / Q000166:cytology*; D005260:Female; D005298:Fertility / Q000502:physiology*; D005307:Fertilization in Vitro / Q000379:methods / Q000592:standards*; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013094:Spermatozoa / Q000166:cytology* / Q000502:physiology*; D014649:Vas Deferens / Q000166:cytology / Q000502:physiology; D015044:Zona Pellucida / Q000502:physiology