title: Repetitive percutaneous epididymal sperm aspirations (PESA's) resulted in asthenospermia and significant inflammation.
abstract: BACKGROUND
  In obstructive azoospermia, choosing a sperm retrieval method for intracytoplasmic sperm injection (ICSI) depends on the preference and expertise of both the urologist and the reproductive endocrinologist. Generally, a percutaneous epididymal sperm aspiration (PESA) is attempted first. Not uncommonly, multiple PESA's are necessary. This study utilizes a rat model to provide an understanding of sperm parameter and histological changes resulting from repetitive PESA procedures.
  
  
  METHODS
  A cohort of 30 male Wistar rats of reproductive age (68-73 days) was divided into three groups of 10 (G1-G3). All three groups underwent a left epididymal head PESA using a 253/8 gauge needle. The untouched right epididymis acted as the control. At 14 day intervals, G2 and G3 underwent a second and third PESA respectively. Fourteen days after the final PESA, both epididymides and a 1 cm segment of both vas deferentia were harvested for sperm and histological evaluations.
  
  
  RESULTS
  The percentage of vas specimens with a sperm count ≥ 5 x104/cc was 100%, 22%, and 20% for the G1, G2, G3 PESA samples respectively. Moreover, the percentage of the vas specimens with sperm motility ≥ 10% was 90%, 22%, and 20%, respectively. Epididymal granulomas were not seen in the control side, but formed in 70%, 100%, and 80% of G1, G2, G3 PESA specimens, respectively.
  
  
  CONCLUSIONS
  In a rat model, PESA resulted in significant epididymal inflammation and a reduction in both sperm concentration and motility.
authors.affiliation: SUNY Upstate Medical University, Syracuse, New York, USA.
authors.forename: Yachao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Kazim R
authors.initials: KR
authors.lastname: Chohan
authors.forename: Steve K
authors.initials: SK
authors.lastname: Landas
authors.forename: Jay E
authors.initials: JE
authors.lastname: Reeder
authors.forename: J C
authors.initials: JC
authors.lastname: Trussell
mesh_terms: D000818:Animals; D053627:Asthenozoospermia / Q000209:etiology*; D053713:Azoospermia / Q000628:therapy; D004195:Disease Models, Animal; D004822:Epididymis; D004823:Epididymitis / Q000209:etiology*; D006099:Granuloma / Q000209:etiology; D008297:Male; D051381:Rats; D055101:Semen Analysis; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval / Q000009:adverse effects*