Objective: This study was made to evaluate efficacy and success rate of Percutaneous Epididymal Sperm Aspiration (PESA), Microsurgical Epididymal Sperm Aspiration (MESA), or Testicular Sperm Extraction (TESE) in azoopsermic patients, and evaluate IVF program’s pregnancy rate by comparing methods of sperm retrieval. Material & method: A descriptive retrospective study to azoospermic patients undergone PESA, MESA or TESE and IVF program in Bunda Hospital Jakarta and Cipto Mangunkusumo Hospital Jakarta in 2011–2012. The data were collected from patients’ medical records and IVF program’s database. Results: There were 146 azoospermic patients with mean age 38.97 ± 7.35 years. Viable sperm was found in 46 patients (31.5%) by PESA and 47 patients (32.2%) by MESA and TESE. The IVF program was followed by 72 patients. Sperm was retrieved by PESA in 43 patients (59.7%) and TESE in 29 patients (40.3%). Pregnancy was achieved in 18 patients in PESA group (25%) and 15 patients (20.8%) in TESE group. Conclusion: Sperm can be retrieved from azoospermic patients by PESA, MESA or TESE, and there was good success rate in pregnancy rate of IVF program by using surgically retrieved sperm.
Azoospermia, Surgical Sperm Retrieval, PESA, MESA, TESE, IVF
Gurunath S, Pandian Z, Anderson RA. Defining infertility–a systematic review of prevalence studies. Human Reproduction Update. 2011; 17(5): 575-88.
Zegers-Hochschild F, Adamson GD, de Mouzon J. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009; 92(5): 1520-4.
Boivin J, Bunting L, Collins JA. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human Reproduction. 2007; 22(6): 1506-12.
Hammarberg K, Baker HWG, Fisher JRW. Men's experiences of infertility and infertility treatment 5 years after diagnosis of male factor infertility: a retrospective cohort study. Human Reproduction. 2010; 25(11): 2815-20.
Dohle GR, Colpi GM, Hargreave TB. EAU guidelines on male infertility. Eur Urol. 2005; 48(5): 703-11.
Krausz C. Male infertility: pathogenesis and clinical diagnosis. Best Pract Res Clin Endocrinol Metab. 2011; 25(2): 271-85.
Dohle GR, Ramos L, Pieters MH. Surgical sperm retrieval and intracytoplasmic sperm injection as treatment of obstructive azoospermia. Human Reproduction. 1998; 13(3): 620-3.
Mercan R, Urman B, Alatas C. Outcome of testicular sperm retrieval procedures in non-obstructive azoospermia: percutaneous aspiration versus open biopsy. Human Reproduction. 2000; 15(7): 1548-51.
Esteves SC, Miyaoka R, Agarwal A. Sperm retrieval techniques for assisted reproduction. Int Braz J Urol. 2011; 37(5): 570-83.
Bromage SJ, Falconer DA, Lieberman BA. Sperm Retrieval Rates in Subgroups of Primary Azoospermic Males. European Urology. 2007; 51(2): 534-40.
Van Perperstraten AM, Proctor ML, Phillipson G. Techniques for surgical retrieval of sperm prior to ICSI for azoospermia. Cochrane Database Syst Rev. 2001; 4: CD002807.
Levine LA, Dimitriou RJ, Fakouri B. Testicular and epididymal percutaneous sperm aspiration in men with either obstructive or nonobstructive azoospermia. Urology. 2003; 62(2): 328-32.
Semiao-Francisco L, Braga DP, Figueira Rde C. Assisted reproductive technology outcomes in azoospermic men: 10 years of experience with surgical sperm retrieval. Aging Male. 2010; 13(1): 44-50.
Pasqualotto FF, Rossi-Ferragut LM, Rocha CC. Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm obtained from patients with obstructive and nonobstructive azoospermia. J Urol. 2002; 167(4): 1753-6.
Van Peperstraten A, Proctor ML, Johnson NP. Techniques for surgical retrieval of sperm prior to intra-cytoplasmic sperm injection (ICSI) for azoospermia. Cochrane Database Syst Rev. 2008; 2: CD002807.
Hargreave TB. Genetic basis of male fertility. British Medical Bulletin. 2000; 56(3): 650-71.
Chandley AC. The genetic basis of male infertility. Reproductive Medicine Review. 1995; 4(01): 1-8.