The difficult MESA: findings from tubuli recti sperm aspiration.
OBJECTIVE
To investigate sperm quality aspirated from the tubuli recti compared to that obtained from microsurgical epididymal sperm aspiration (MESA).


METHODS
Sixteen patients with congenital bilateral absence of the vas deferens (CBAVD) underwent MESA. Six MESA procedures were difficult, and therefore sperm were retrieved from the tubuli recti ductules. Intraoperative sperm parameters, recovery after freeze-thaw, and ICSI outcomes were analyzed and compared between tubuli recti and MESA sperm.


RESULTS
Mean initial sperm concentration was similar in both groups (18 vs. 16 million sperm/mL). Initial sperm motility was significantly higher in the tubuli recti group (35%) than the MESA group (25%). However, post thaw motility was higher with MESA compared to tubuli recti sperm (8.7 vs. 1.5%). ICSI fertilization rates after sperm freeze-thaw were 66% for tubuli recti sperm and 71% for MESA sperm.


CONCLUSIONS
Tubuli recti sperm may provide an attractive alternative to testis sperm extraction. Poor sperm recovery after freeze-thaw should be expected.
Zenke
Ulrike
U
Department of Urology, University of California San Francisco School of Medicine, San Francisco, California 94143-1695, USA.
Jalalian
Liza
L
Shen
Shehua
S
Turek
Paul J
PJ
D004822:Epididymis / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012152:Rete Testis / Q000166:cytology*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013081:Sperm Motility; D013094:Spermatozoa / Q000166:cytology*; D013396:Suction; D014649:Vas Deferens / Q000002:abnormalities