Performing testicular or epididymal sperm retrieval prior to the injection of hCG.
OBJECTIVE
Our purpose was to determine the feasibility and efficacy of performing testicular or epididymal sperm retrieval prior to the injection of human chorionic gonadotropin (hCG).


METHODS
This report deals with 87 sperm-positive percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sperm aspiration (PTSA), or testicular sperm extraction (TESE) cycles. All sperm retrieval procedures were performed prior to administration of hCG to the women. Retrieved spermatozoa were cultured in vitro in simple medium for approximately 40 hr prior to intracytoplasmic sperm injection.


RESULTS
In all but one cycle in which TESE was performed for nonobstructive azoospermia, motile sperm were available for ICSI. The overall fertilization rate was 53%. Pregnancy rate per transfer and implantation rate per embryo were 41.2 and 15.7%, respectively.


CONCLUSIONS
Satisfactory fertilization and pregnancy rates can be achieved when PESA, PTSA, or TESE is performed prior to the injection of hCG followed by in vitro culture of spermatozoa approximately 40 hr before ICSI. Scheduling of testicular or epididymal sperm retrieval cases in this way appears to ease the workload on laboratory and operating room personnel. Furthermore, withholding hCG when sperm is absent may obviate the unnecessary risk of ovarian hyperstimulation when spermatozoa cannot be retrieved.
Urman
B
B
Assisted Reproductive Technology Unit, American Hospital of Istanbul, Turkey.
Alatas
C
C
Aksoy
S
S
Nuhoglu
A
A
Sertac
A
A
Balaban
B
B
D001706:Biopsy; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000009:adverse effects; D004822:Epididymis / Q000166:cytology / Q000502:physiology / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D008297:Male; D009845:Oligospermia / Q000473:pathology / Q000628:therapy; D016471:Ovarian Hyperstimulation Syndrome / Q000139:chemically induced / Q000517:prevention & control; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D013081:Sperm Motility / Q000502:physiology; D013094:Spermatozoa / Q000502:physiology*; D013396:Suction; D013737:Testis / Q000166:cytology / Q000502:physiology / Q000601:surgery*; D013997:Time Factors
D006063:Chorionic Gonadotropin