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Superior clinical pregnancy rates after microsurgical epididymal sperm aspiration
Authors:Hatsuki Hibi  Makoto Sumitomo  Noritaka Fukunaga  Megumi Sonohara  Yoshimasa Asada
Institution:1. Department of Urology, Kyoritsu General Hospital, Nagoya, Japan;2. Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan;3. Asada Ladies Clinic, Nagoya, Japan
Abstract:

Purpose

To assess normal fertilization, clinical pregnancy, and live birth rates after the use of microscopic epididymal sperm aspiration (MESA).

Methods

One‐hundred‐and‐sixty azoospermic participants who underwent MESA were evaluated. The MESA was performed by using a micropuncture method with a micropipette. In cases in which motile sperm were not obtained after the MESA, conventional or micro‐testicular sperm extraction (TESE) was completed.

Results

Adequate motile sperm were retrieved in 71 participants by using MESA and in 59 out of 89 participants by using TESE. Of the total number of patients, 123 underwent intracytoplasmic sperm injection. After MESA, the normal fertilization rate was 73.5% and the clinical pregnancy rate per case was 95.7%. Healthy deliveries resulted after MESA in 65 (92.9%) cases and after TESE in 38 (71.7%) cases.

Conclusion

The MESA specimen collection does not have any special requirements, such as mincing tissue disposition. The MESA also can reduce the amount of laboratory work that is needed for cryopreservation. In the authors' experience, MESA is a beneficial procedure and should be given priority over TESE.
Keywords:azoospermia  cryopreservation  intracytoplasmic sperm injection outcome  microscopic epididymal sperm aspiration  sperm retrieval
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