Percutaneous epididymal sperm aspiration followed by intrauterine insemination--a new approach to achieve a pregnancy in infertility due to obstructive azoospermia

Standard approach towards treatment of obstructive azoospermia whether congenital or acquired is mostly microsurgical epididymal sperm aspiration (MESA) and to some extent percutaneous epididymal sperm aspiration (PESA) both being followed by intracytoplasmic sperm injection (ICSI). However in the present series for sperm retrieval in case of obstructive azoospermia the author conducted a series of 55 cases of PESA along with only 4 cases of MESA. The epididymal sperm aspiration (ESA) was followed by intrauterine insemination (IUI) (whenever required quantity of motile sperm was collected) in place of ICSI with full consent of the couples. With the help of this ESA-IUI programme it was possible to achieve reasonable success rate viz, 20% pregnancy rate (PR) per cycle for PESA-IUI and 14.28% for MESA-IUI.