Successful pregnancy and birth after intrauterine insemination using caput epididymal sperm by percutaneous aspiration.
OBJECTIVE
To manage male infertility with obstructive azoospermia by means of percutaneous epididymal sperm aspiration (PESA) and intrauterine insemination (IUI).


METHODS
Ninety azoospermic patients with congenital bilateral absence of the vas deferens (BAVD, n=58) or bilateral caudal epididymal obstruction (BCEO, n=32) requesting for fine needle aspiration (FNA), PESA and IUI were recruited. The obstruction was diagnosed by vasography and determination of the fructose, carnitine and alpha-glucosidase levels in the seminal fluid.


RESULTS
The mean sperm motility, density, abnormal sperm and total sperm count of the caput epdidymis were 16 %+/-22 %, (12+/-31) x 10(6)/mL, 55 %+/-36 % and (16+/-14) x 10(6), respectively. In the 90 couples, a total of 74 PESA procedures and 66 cycles of IUI were performed. Three pregnancies resulted, including one twin pregnancy giving birth to two healthy boys, one single pregnancy with a healthy girl and another single pregnancy aborted at week 6 of conception. The pregnancy rate per IUI cycle was 4.5 %.


CONCLUSIONS
The birth of normal, healthy infants by IUI using PESA indicates that the caput epididymal sperm possess fertilization capacity. The PESA-IUI programme is a practical and economical procedure for the management of patients with obstructive azoospermia.
Qiu
Yi
Y
Shandong Institute for Family Planning Research, Jinan 250002, China. qiuyimail@yahoo.com
Yang
Dan-Tong
DT
Wang
Su-Mei
SM
Sun
Hui-Qing
HQ
Jia
Yi-Fang
YF
D000328:Adult; D001707:Biopsy, Needle; D004822:Epididymis / Q000166:cytology*; D005260:Female; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D009845:Oligospermia / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013094:Spermatozoa / Q000166:cytology*