title: Analysis of intra-operative aspirates taken during microsurgical refertilization in obstructive azoospermia--preliminary results. The BMFT Study Group for Microsurgery, Giessen.
abstract: The reasons for the discrepancy between 'patency' and 'pregnancy' in the outcome of microsurgical refertilization are partially unknown. The quality of the intra-operative aspirate and of the spermatozoa at the level of the anastomosis are discussed worldwide as important factors influencing the success of fertilization in the case of post-operative patency. In 152 men undergoing microsurgical refertilization (vasovasostomy, tubulovasostomy, microsurgical epididymal sperm aspiration, transurethral resection of the ejaculatory duct), 281 aspirates were classified intra-operatively according to Silber, and post-operatively using the Shorr staining technique. In 62 aspirates a computer-aided sperm analysis (CASA) was performed. The percentage of intact spermatozoa decreased from 94.9% at the caput to 9.4% at the cauda epididymidis. The post-operative classification demonstrated an acceptable correlation (0.71) to all grades of intraoperative classification. There was a good correspondence in Silber 4 and 5 but worse in Silber 1 and 2. In CASA, the percentage of motile spermatozoa was not different between epididymal and post-epididymal aspirates. Furthermore, velocity parameters did not differ significantly, but there was a significantly higher straightness of post-epididymal spermatozoa in comparison to epididymal spermatozoa.
authors.affiliation: Department of Urology, University of Giessen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Schroeder-Printzen
authors.forename: G
authors.initials: G
authors.lastname: Haidl
authors.forename: E
authors.initials: E
authors.lastname: Ernst
authors.forename: W H
authors.initials: WH
authors.lastname: Weiske
authors.forename: J
authors.initials: J
authors.lastname: Zumbé
authors.forename: M
authors.initials: M
authors.lastname: Dandal
authors.forename: F M
authors.initials: FM
authors.lastname: Köhn
authors.forename: W
authors.initials: W
authors.lastname: Weidner
mesh_terms: D000328:Adult; D002469:Cell Separation; D004822:Epididymis / Q000166:cytology; D006801:Humans; D001239:Inhalation; D007432:Intraoperative Period; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009845:Oligospermia / Q000209:etiology / Q000601:surgery*; D013081:Sperm Motility; D013094:Spermatozoa / Q000502:physiology*; D013737:Testis / Q000166:cytology