Andrology: Percutaneous epididymal sperm aspiration for obstructive azoospermia

We report the use of percutaneous epididymal sperm aspirationas a simpler and more acceptable alternative to microscopicepididymal sperm aspiration for patients with obstructive azoospermiain whom bypass surgery is not feasible or has not been successful.Some contamination of the aspirate with blood is inevitable,but with careful sperm preparation techniques this can be reducedsubstantially in the final aliquot used for assisted conception.Spermatozoa with active forward progression may be used forgamete intra-Fallopian transfer treatment, but when this capacityis absent intracytoplasmic sperm injection is recommended. Threepregnancies were obtained in seven couples and a set of twinshas been delivered.