title: Intracytoplasmic sperm injection using microsurgically retrieved epididymal and testicular sperm.
abstract: OBJECTIVE
  To evaluate treatment of couples who are infertile due to unreconstructable obstructive azoospermia with microsurgical epididymal sperm aspiration or testicular sperm and intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Prospective.
  
  
  METHODS
  The Egyptian IVF-ET Center in association with Cairo University.
  
  
  METHODS
  Twenty-three couples who are infertile due to obstructive azoospermia in which reconstructive microsurgery failed or was not possible.
  
  
  METHODS
  Microsurgical epididymal or testicular sperm retrieval and ICSI in 24 cycles.
  
  
  METHODS
  Fertilization and pregnancies.
  
  
  RESULTS
  All 24 cycles had successful fertilization and reached the ET stage. In microsurgical epididymal sperm aspiration cases, fertilization rate per metaphase II oocyte was 63% (109/ 172). Six patients became pregnant, including one set of twins and one set of triplets. One pregnancy resulted from the use of cryothawed epididymal sperm. In testicular sperm aspiration cases, the fertilization rate was 59% (32/54) and four clinical pregnancies resulted.
  
  
  CONCLUSIONS
  The use of microepididymal sperm aspiration or testicular sperm aspiration in conjunction with ICSI provide a highly precise and efficient procedure for achieving pregnancy in cases of unreconstuctable obstructive azoospermia.
authors.affiliation: Egyptian IVF-ET Center, Cairo, Egypt.
authors.forename: R T
authors.initials: RT
authors.lastname: Mansour
authors.forename: M A
authors.initials: MA
authors.lastname: Aboulghar
authors.forename: G I
authors.initials: GI
authors.lastname: Serour
authors.forename: I
authors.initials: I
authors.lastname: Fahmi
authors.forename: A M
authors.initials: AM
authors.lastname: Ramzy
authors.forename: Y
authors.initials: Y
authors.lastname: Amin
mesh_terms: D000328:Adult; D015925:Cryopreservation; D003593:Cytoplasm; D004622:Embryo, Mammalian; D004822:Epididymis / Q000601:surgery*; D005260:Female; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000628:therapy; D008297:Male; D008845:Microinjections; D008846:Micromanipulation; D008866:Microsurgery; D009845:Oligospermia / Q000150:complications; D011247:Pregnancy; D011446:Prospective Studies; D012099:Reproductive Techniques; D012662:Semen Preservation; D013048:Specimen Handling / Q000379:methods; D013094:Spermatozoa; D013737:Testis / Q000601:surgery*