title: Percutaneous epididymal sperm aspiration for men with obstructive azoospermia: predictors of successful sperm retrieval.
abstract: OBJECTIVE
  To evaluate the predictors of successful sperm retrieval using percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia (OA).
  
  
  METHODS
  Data were collected retrospectively from 255 patients with OA who underwent PESA between March 2007 and September 2012. Sperm retrieval outcomes were reported as motile sperm (>1% motile), rare motile sperm (≤1% motile), nonmotile sperm, and no sperm found. Variables included in our analysis were patient age, testicular volume, and diagnosis (congenital bilateral absence of the vas deferens, vasectomy, failed vasovasostomy, or other). Multivariate logistic regression models were constructed to detect variables prognostic for successful PESA outcomes.
  
  
  RESULTS
  After PESA, motile sperm were detected in 192 patients (75.3%), rare motile sperm in 24 (9.4%), nonmotile sperm in 27 (10.6%), and no sperm in 12 (4.7%). There was no difference among the groups in terms of median testicular volume or diagnosis. However, there was a significantly higher median age (P = .0234) in men who had no sperm (45 years) or nonmotile sperm (46 years) compared with those who had motile (41 years) or rare motile sperm (40 years). On multivariate analysis, larger testicular volume was independently prognostic for improved motile sperm retrieval rates (P = .0056) whereas increased paternal age strongly trended toward lower rates (P = .0589).
  
  
  CONCLUSIONS
  The data suggest that PESA yields good motile sperm retrieval rates in patients with OA. Younger paternal age and larger testicular volume appear to be predictive of higher motile sperm retrieval rates.
authors.affiliation: Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Faysal A
authors.initials: FA
authors.lastname: Yafi
authors.forename: Armand
authors.initials: A
authors.lastname: Zini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D053713:Azoospermia / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013081:Sperm Motility; D053625:Sperm Retrieval; D013737:Testis / Q000033:anatomy & histology*; D014649:Vas Deferens / Q000002:abnormalities; D014659:Vasectomy / Q000009:adverse effects; D014669:Vasovasostomy / Q000009:adverse effects; D055815:Young Adult