Microsurgical vasoepididymostomy with sperm cryopreservation for future assisted reproduction

BACKGROUND: Although obstructive azoospermia is treatable with microscopic seminal reconstruction, the number of patients who choose to undergo vasoepididymostomy is limited because of recent advances in assisted reproductive technology (ART). We attempted to define the outcome of surgical reconstruction in patients with suspected epididymal obstruction and no previous history of vasectomy. METHODS: We described 40 eligible end-to-side vasoepididymostomy procedures performed on 24 azoospermic patients who had either bilateral or unilateral epididymal obstruction. RESULTS: The overall patency rate following surgery was 54% (13/24) and for four patients (17%), natural intercourse resulted in pregnancy. Two pregnancies were initiated with intracytoplasmic sperm injections using frozen sperm collected during vasoepididymostomy. CONCLUSIONS: In the era of modern ART, microsurgical vasoepididymostomy with cryopreservation of sperm collected during the operation is recommended for patients with epididymal obstructions.     

Oocyte cryopreservation: the birth of the first Hungarian babies from frozen oocytes

PURPOSE: To present data obtained with clinical application of oocyte cryopreservation. METHODS: Slow freezing/rapid thawing in PBS based medium containing 1.5 M propanediol + 0.3 M sucrose. RESULTS: A total of 127 embryos were transferred into 54 patients (1.9 embryo/cycle, 64 transfer cycles). Clinical pregnancy rate of 20% per cycle (13/64) and 24.0% per patient were achieved. Up-to-date, six patients delivered seven healthy babies; there are four ongoing pregnancies. Three abortions (23%) and one biochemical pregnancy (0.7%) was obtained. Implantation rates of 11% per transferred embryos (14/127) and 6.5% (14/215) per thawed eggs were found. In each case, normal karyotype was detected. No difference was found in the ratio of spindle positive oocytes at the polscope analyses done before and after freezing (75.8% vs. 82.5%). CONCLUSION: Egg freezing is not a routine procedure yet, but there will certainly be a place for it in the future of assisted reproductive medicine.