title: [Surgical management of male infertility beyond assisted reproductive technology].
abstract: OBJECTIVE
  To investigate the role of urological surgery for male infertility which is beyond the help of assisted reproductive technology (ART).
  
  
  METHODS
  We retrospectively reviewed the records of 7 male infertility patients who, having failed to respond to ART, underwent urological surgery from 1999 to 2003. Of the 7 cases, 4 were varicocele, 2 were post-bilateral vasectomy and 1 was bilateral chronic epididymitis. For the 7 patients, 6 times we performed in vitro fertilization-embryo transfer (IVF-ET) and 5 times we attempted intracytoplasmic sperm injection (ICSI) , but all failed. After that, we resorted to surgical approaches, ligation of internal spermatic veins in 4 cases, bilateral vasovasostomy in 2, and unilateral epididymovasostomy in 1.
  
  
  RESULTS
  After surgical intervention, 2 cases fathered children, 1 achieved pregnancy and 3 cases improved in the quality and quantity of seminal fluid; only 1 failed to respond to the therapy.
  
  
  CONCLUSIONS
  In the treatment of male infertility, priority should be given to surgical intervention and, in case of failure, assisted reproductive technology could be considered.
authors.affiliation: Department of Urology, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong 510230, China.
authors.forename: Guo-hua
authors.initials: GH
authors.lastname: Zeng
authors.forename: Hua
authors.initials: H
authors.lastname: Mei
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000601:surgery* / Q000628:therapy; D008297:Male; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D017211:Treatment Failure; D013521:Urologic Surgical Procedures, Male