Sperm Retrieval: Procedures to obtain viable sperm from the male reproductive tract, including the TESTES, the EPIDIDYMIS, or the VAS DEFERENS.Azoospermia: A condition of having no sperm present in the ejaculate (SEMEN).Oligospermia: A condition of suboptimal concentration of SPERMATOZOA in the ejaculated SEMEN to ensure successful FERTILIZATION of an OVUM. In humans, oligospermia is defined as a sperm count below 20 million per milliliter semen.Tissue and Organ Harvesting: The procedure of removing TISSUES, organs, or specimens from DONORS for reuse, such as TRANSPLANTATION.Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure.Posthumous Conception: Conception after the death of the male or female biological parent through techniques such as the use of gametes that have been stored during his or her lifetime or that were collected immediately after his or her death.Testis: The male gonad containing two functional parts: the SEMINIFEROUS TUBULES for the production and transport of male germ cells (SPERMATOGENESIS) and the interstitial compartment containing LEYDIG CELLS that produce ANDROGENS.Sperm Injections, Intracytoplasmic: An assisted fertilization technique consisting of the microinjection of a single viable sperm into an extracted ovum. It is used principally to overcome low sperm count, low sperm motility, inability of sperm to penetrate the egg, or other conditions related to male infertility (INFERTILITY, MALE).Spermatozoa: Mature male germ cells derived from SPERMATIDS. As spermatids move toward the lumen of the SEMINIFEROUS TUBULES, they undergo extensive structural changes including the loss of cytoplasm, condensation of CHROMATIN into the SPERM HEAD, formation of the ACROSOME cap, the SPERM MIDPIECE and the SPERM TAIL that provides motility.Ejaculation: The emission of SEMEN to the exterior, resulting from the contraction of muscles surrounding the male internal urogenital ducts.Infertility, Male: The inability of the male to effect FERTILIZATION of an OVUM after a specified period of unprotected intercourse. Male sterility is permanent infertility.Reproductive Techniques: Methods pertaining to the generation of new individuals, including techniques used in selective BREEDING, cloning (CLONING, ORGANISM), and assisted reproduction (REPRODUCTIVE TECHNIQUES, ASSISTED).Sperm Count: A count of SPERM in the ejaculum, expressed as number per milliliter.Semen Preservation: The process by which semen is kept viable outside of the organism from which it was derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism).Vasovasostomy: Surgical anastomosis or fistulization of the spermatic ducts to restore fertility in a previously vasectomized male.Sperm Head: The anterior portion of the spermatozoon (SPERMATOZOA) that contains mainly the nucleus with highly compact CHROMATIN material.Microsurgery: The performance of surgical procedures with the aid of a microscope.Epididymis: The convoluted cordlike structure attached to the posterior of the TESTIS. Epididymis consists of the head (caput), the body (corpus), and the tail (cauda). A network of ducts leaving the testis joins into a common epididymal tubule proper which provides the transport, storage, and maturation of SPERMATOZOA.Klinefelter Syndrome: A form of male HYPOGONADISM, characterized by the presence of an extra X CHROMOSOME, small TESTES, seminiferous tubule dysgenesis, elevated levels of GONADOTROPINS, low serum TESTOSTERONE, underdeveloped secondary sex characteristics, and male infertility (INFERTILITY, MALE). Patients tend to have long legs and a slim, tall stature. GYNECOMASTIA is present in many of the patients. The classic form has the karyotype 47,XXY. Several karyotype variants include 48,XXYY; 48,XXXY; 49,XXXXY, and mosaic patterns ( 46,XY/47,XXY; 47,XXY/48,XXXY, etc.).Sperm Capacitation: The structural and functional changes by which SPERMATOZOA become capable of oocyte FERTILIZATION. It normally requires exposing the sperm to the female genital tract for a period of time to bring about increased SPERM MOTILITY and the ACROSOME REACTION before fertilization in the FALLOPIAN TUBES can take place.Tuberculosis, Male Genital: MYCOBACTERIUM infections of the male reproductive tract (GENITALIA, MALE).Autonomic Dysreflexia: A syndrome associated with damage to the spinal cord above the mid thoracic level (see SPINAL CORD INJURIES) characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention. Manifestations include HYPERTENSION; TACHYCARDIA (or reflex bradycardia); FEVER; FLUSHING; and HYPERHIDROSIS. Extreme hypertension may be associated with a STROKE. (From Adams et al., Principles of Neurology, 6th ed, pp538 and 1232; J Spinal Cord Med 1997;20(3):355-60)Cryopreservation: Preservation of cells, tissues, organs, or embryos by freezing. In histological preparations, cryopreservation or cryofixation is used to maintain the existing form, structure, and chemical composition of all the constituent elements of the specimens.Microdissection: The performance of dissections with the aid of a microscope.Testicular Diseases: Pathological processes of the TESTIS.Information Storage and Retrieval: Organized activities related to the storage, location, search, and retrieval of information.Sperm Motility: Movement characteristics of SPERMATOZOA in a fresh specimen. It is measured as the percentage of sperms that are moving, and as the percentage of sperms with productive flagellar motion such as rapid, linear, and forward progression.Fertilization in Vitro: An assisted reproductive technique that includes the direct handling and manipulation of oocytes and sperm to achieve fertilization in vitro.Reproductive Techniques, Assisted: Clinical and laboratory techniques used to enhance fertility in humans and animals.Pregnancy Rate: The ratio of the number of conceptions (CONCEPTION) including LIVE BIRTH; STILLBIRTH; and fetal losses, to the mean number of females of reproductive age in a population during a set time period.Spermatogenesis: The process of germ cell development in the male from the primordial germ cells, through SPERMATOGONIA; SPERMATOCYTES; SPERMATIDS; to the mature haploid SPERMATOZOA.Mental Recall: The process whereby a representation of past experience is elicited.Embryo Transfer: The transfer of mammalian embryos from an in vivo or in vitro environment to a suitable host to improve pregnancy or gestational outcome in human or animal. In human fertility treatment programs, preimplantation embryos ranging from the 4-cell stage to the blastocyst stage are transferred to the uterine cavity between 3-5 days after FERTILIZATION IN VITRO.Sperm Maturation: The maturing process of SPERMATOZOA after leaving the testicular SEMINIFEROUS TUBULES. Maturation in SPERM MOTILITY and FERTILITY takes place in the EPIDIDYMIS as the sperm migrate from caput epididymis to cauda epididymis.Microinjections: The injection of very small amounts of fluid, often with the aid of a microscope and microsyringes.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body.Specimen Handling: Procedures for collecting, preserving, and transporting of specimens sufficiently stable to provide accurate and precise results suitable for clinical interpretation.Sperm Transport: Passive or active movement of SPERMATOZOA from the testicular SEMINIFEROUS TUBULES through the male reproductive tract as well as within the female reproductive tract.Oocyte Retrieval: Procedures to obtain viable OOCYTES from the host. Oocytes most often are collected by needle aspiration from OVARIAN FOLLICLES before OVULATION.Sperm-Ovum Interactions: Interactive processes between the oocyte (OVUM) and the sperm (SPERMATOZOA) including sperm adhesion, ACROSOME REACTION, sperm penetration of the ZONA PELLUCIDA, and events leading to FERTILIZATION.Pregnancy Outcome: Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; SPONTANEOUS ABORTION; INDUCED ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.Acrosome: The cap-like structure covering the anterior portion of SPERM HEAD. Acrosome, derived from LYSOSOMES, is a membrane-bound organelle that contains the required hydrolytic and proteolytic enzymes necessary for sperm penetration of the egg in FERTILIZATION.Fertilization: The fusion of a spermatozoon (SPERMATOZOA) with an OVUM thus resulting in the formation of a ZYGOTE.Follicle Stimulating Hormone: A major gonadotropin secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR). Follicle-stimulating hormone stimulates GAMETOGENESIS and the supporting cells such as the ovarian GRANULOSA CELLS, the testicular SERTOLI CELLS, and LEYDIG CELLS. FSH consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity.Sperm Midpiece: The middle piece of the spermatozoon is a highly organized segment consisting of MITOCHONDRIA, the outer dense fibers and the core microtubular structure.Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory.Biopsy, Needle: Removal and examination of tissue obtained through a transdermal needle inserted into the specific region, organ, or tissue being analyzed.Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains SPERMATOZOA and their nutrient plasma.Sperm Banks: Centers for acquiring and storing semen.Semen Analysis: The quality of SEMEN, an indicator of male fertility, can be determined by semen volume, pH, sperm concentration (SPERM COUNT), total sperm number, sperm viability, sperm vigor (SPERM MOTILITY), normal sperm morphology, ACROSOME integrity, and the concentration of WHITE BLOOD CELLS.Zona Pellucida: A tough transparent membrane surrounding the OVUM. It is penetrated by the sperm during FERTILIZATION.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Fertility: The capacity to conceive or to induce conception. It may refer to either the male or female.Abstracting and Indexing as Topic: Activities performed to identify concepts and aspects of published information and research reports.Memory, Episodic: Type of declarative memory, consisting of personal memory in contrast to general knowledge.Semantics: The relationships between symbols and their meanings.Sperm Whale: The species Physeter catodon (also called Physeter macrocephalus), in the family Physeteridae. The common name is derived from the milky wax substance in its head (spermaceti). The species also produces an intestinal secretion AMBERGRIS, which was previously used in perfumes. The sperm whale is the largest toothed MAMMAL in the world.Device Removal: Removal of an implanted therapeutic or prosthetic device.
AzoospermiaFNA Mapping: Fine needle aspiration (FNA) cytology has been used to examine pathological human tissue from various organs for over 100 years.,Posner C.Suction (medicine): In medicine, devices are sometimes necessary to create suction. Suction may be used to clear the airway of blood, saliva, vomit, or other secretions so that a patient may breathe.Karin Dubsky: Karin Dubsky (born 1954), is a German-Irish marine ecologist working in Trinity College Dublin, and is the coordinator and co-founder of Coastwatch Europe, an environmental NGO and a member of the European Environmental Bureau.Blood–testis barrier: The blood–testis barrier is a physical barrier between the blood vessels and the seminiferous tubules of the animal testes. The name "blood-testis barrier" is misleading in that it is not a blood-organ barrier in a strict sense, but is formed between Sertoli cells of the seminiferous tubule and as such isolates the further developed stages of germ cells from the blood.Reproductive technology: Reproductive technology (RT) encompasses all current and anticipated uses of technology in human and animal reproduction, including assisted reproductive technology, contraception and others.Spermiogenesis: Spermiogenesis is the final stage of spermatogenesis, which sees the maturation of spermatids into mature, motile spermatozoa. The spermatid is more or less circular cell containing a nucleus, Golgi apparatus, centriole and mitochondria.Retrograde ejaculationMale infertilitySperm: Sperm is the male reproductive cell and is derived from the Greek word (σπέρμα) sperma (meaning "seed"). In the types of sexual reproduction known as anisogamy and its subtype oogamy, there is a marked difference in the size of the gametes with the smaller one being termed the "male" or sperm cell.VasovasostomyHook protein: HOOK is a family of evolutionarily related proteins.Chen Zhongwei: Chen Zhongwei (Chinese:陈中伟, 1929–2004) was an expert of orthopedic surgery and microsurgery, one of the pioneers of the process of reattaching severed limbs.Epididymis: The epididymis (; plural: epididymides or ) is a tube that connects a testicle to a vas deferens in the male reproductive system. It is present in all male reptiles, birds, and mammals.Polysomy: Polysomy is a condition found in many species, including fungi, plants, insects, and mammals, in which an organism has at least one more chromosome than normal, i.e.HyperreflexiaOvarian tissue cryopreservation: Ovarian tissue cryopreservation is cryopreservation of tissue of the ovary of a female.Orchialgia: Orchialgia is long-term pain of the testes. It is considered chronic if it has persisted for more than 3 months.Conference and Labs of the Evaluation Forum: The Conference and Labs of the Evaluation Forum (formerly Cross-Language Evaluation Forum), or CLEF, is an organization promoting research in multilingual information access (currently focusing on European languages). Its specific functions are to maintain an underlying framework for testing information retrieval systems and to create repositories of data for researchers to use in developing comparable standards.Hyperactivation: Hyperactivation is a type of sperm motility. Hyperactivated sperm motility is characterised by a high amplitude, asymmetrical beating pattern of the sperm tail (flagellum).Natural cycle in vitro fertilization: Natural Cycle IVF is in vitro fertilisation (IVF) using either of the following procedures:Pregnancy rate: Pregnancy rate is the success rate for getting pregnant. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which may be simple artificial insemination (AI) or AI with additional in vitro fertilization.Spaced retrieval: Spaced retrieval, also known as expanded retrieval or uniform retrieval, is a learning technique, which requires users to rehearse information to be learned at different and increasing spaced intervals of time or a set uniform amount of time.Haslam, C.Embryo transfer: Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique (which is often used in connection with in vitro fertilization (IVF)), may be used in humans or in animals, in which situations the goals may vary.Prenatal nutrition: Nutrition and weight management before and during :pregnancy has a profound effect on the development of infants. This is a rather critical time for healthy fetal development as infants rely heavily on maternal stores and nutrient for optimal growth and health outcome later in life.Brain biopsyPostcoital test: The postcoital test (PCT) (also known as Sims test, Huhner test or Sims-Huhner test) is a test in the evaluation of infertility. The test examines interaction between sperm and mucus of the cervix.Explicit memory: Explicit memory is the conscious, intentional recollection of previous experiences and information. People use explicit memory throughout the day, such as remembering the time of an appointment or recollecting an event from years ago.Breast biopsySemen quality: Semen quality is a measure of the ability of semen to accomplish fertilization. Thus, it is a measure of fertility in a man.Screening of potential sperm bank donors: In sperm banks, screening of potential sperm donors typically includes genetic diseases, chromosomal abnormalities and sexually transmitted infections that may be transmitted through sperm. The screening procedure generally also includes a quarantine period, in which the samples are frozen and stored for at least 6 months after which the donor will be re-tested for the STIs.Gastrocopta pellucida: Gastrocopta pellucida is a species of minute air-breathing land snail, a terrestrial pulmonate gastropod mollusk or micromollusk in the family Vertiginidae, the vertigo snails.Low Fertility Cohorts Study: The Low Fertility Cohorts Study, 1978: A Survey of White, Ever-Married Women Belonging to the 1901-1910 United States Birth Cohorts,Data Sharing For Demographic Research consists of personal interviews of white, ever-married women born between July 1, 1900, and June 30, 1910. In 1978, a national survey of 1,049 married women between the ages of 68 and 78 were interviewed between the months of March and July in order to investigate low fertility during the 1920s and 1930s and the women of childbearing age during those decades.Time-Based Prospective Memory: Time-based prospective memory is a type of prospective memory in which remembrance is triggered by a time-related cue that indicates that a given action needs to be performed. An example is remembering to watch a television program at 3 p.Concurrency semantics: In computer science, concurrency semantics is a way to give meaning to concurrent systems in a mathematically rigorous way. Concurrency semantics is often based on mathematical theories of concurrency such as various process calculi, the actor model, or Petri nets.
(1/76) Can inhibin-B predict the outcome of microsurgical epididymal sperm aspiration in patients with suspected primary obstructive azoospermia.
AIM: To evaluate whether inhibin-B can predict the outcome of a microsurgical epidymal sperm aspiration (MESA) procedure in patients with suspected primary obstructive azoospermia (OA) and if inhibin-B can replace testicular biopsy in the diagnostic work-up of these patients. METHODS: Inhibin-B levels and testicular biopsy scores were related to the outcome of MESA in 43 patients with suspected primary OA. MESA was considered to be successful when epididymal sperm could be identified during the procedure. RESULTS: Spermatozoa were present in the epididymal aspirate in 28 out of the 43 patients (65%). Inhibin-B values were not significantly different in patients with successful or unsuccessful MESA. The modified Johnsen score, however, was significantly lower in patients with unsuccessful MESA (P = 0.003). A rete testis obstruction or epididymal malfunctioning was found in 15% of patients with suspected primary OA, reflected by unsuccessful MESA despite normal inhibin-B levels and normal testicular histology. CONCLUSION: Inhibin-B cannot replace testicular biopsy as a diagnostic tool in the work-up of patients with suspected primary OA. Testicular biopsy is useful in identifying patients with spermatogenic arrest, who might have normal inhibin-B values. (+info)
(2/76) Histological evaluation of the human testis--approaches to optimizing the clinical value of the assessment: mini review.
Testicular biopsy is a crucial assessment in reproductive practice with diagnostic and prognostic importance for assisted reproductive technologies (ARTs) and risk of testicular neoplasia. Endocrine and genetic tests cannot reliably distinguish obstructive azoospermia (OA) from non-obstructive azoospermia (NOA) or predict recovery of mature spermatids by testicular sperm extraction (TESE). Currently, divergent histological reporting systems and the use of imprecise terminology seriously degrade the value of the literature on TESE recovery rates and hamper evaluation of treatments and research on genotype-phenotype relationships. The rising incidence of testis cancer and carcinoma in situ (CIS), especially in infertile populations, requires that every effort be made for its early detection. We provide a systematic approach to the histological classification of spermatogenic disorders and detection of CIS in adult patients. We evaluate a large consecutive series of bilateral biopsies from infertile men and report (i) the frequency of bilateral or discordant patterns that supports the use of bilateral biopsy for comprehensive evaluation and (ii) a high prevalence of mixed patterns, particularly within the hypospermatogenesis classification, that helps account for reported success of TESE. We propose a new diagnosis code for testicular biopsies that addresses the needs of ART clinicians and allows data storage and retrieval of value in clinical practice and research. (+info)
(3/76) Posthumous sperm retrieval: analysis of time interval to harvest sperm.
BACKGROUND: Current recommendations regarding posthumous sperm retrieval (PSR) are based on a small number of cases. Our purpose was to determine the time interval from death to a successful procedure. METHODS: Seventeen consecutive PSR procedures in 14 deceased and 3 neurologically brain-dead patients at two male infertility centres [Sheba Medical Center (SMC), Tel-Hashomer, Israel and University of California San Francisco (UCSF), San Francisco, CA, USA] were analysed. Main outcome measures were retrieval of vital sperm, pregnancies and births. RESULTS: PSR methods included resection of testis and epididymis (n = 8), en-block excision of testis, epididymis and proximal vas deferens with vasal irrigation (n = 6), electroejaculation (EEJ) (n = 2) and epididymectomy (n = 1). PSR was performed 7.5-36 h after death. Sperm was retrieved in all cases and was motile in 14 cases. In two cases, testicular and epididymal tissues were cryopreserved without sperm evaluation, and in one case, no motility was detected. IVF and ICSI were performed in two cases in which sperm had been retrieved 30 h after death, and both resulted in pregnancies and live births. CONCLUSIONS: Viable sperm is obtainable with PSR well after the currently recommended 24-h time interval. PSR should be considered up to 36 h after death, following appropriate evaluation. No correlation was found between cause of death and chance for successful sperm retrieval. (+info)
(4/76) First recorded pregnancy and normal birth after ICSI using electrophoretically isolated spermatozoa.
BACKGROUND: DNA damage in the male germ line is associated with poor fertilization and cleavage rates, impaired embryo quality and early pregnancy loss. Given these associations, embryologists are keen to develop techniques that will allow the selection of viable spermatozoa exhibiting low levels of DNA damage for assisted conception purposes. METHODS: In this article, we describe a novel electrophoretic approach for the rapid isolation of cells possessing little DNA damage. The limits of the method were examined using cryostored and snap-frozen semen samples as well as testicular biopsy material. In addition, clinical utility was demonstrated in a case study involving treatment of a patient exhibiting persistently high levels of DNA damage in his spermatozoa. RESULTS: From a range of difficult starting materials (biopsies, cryostored semen and snap-frozen sperm suspensions), the electrophoretic system rapidly isolated populations of motile, viable, morphologically normal spermatozoa exhibiting high levels of DNA integrity. Clinical application in a couple suffering from long-term infertility associated with extensive DNA damage in the male germ line led to the first human pregnancy following such electrophoretic sperm isolation. CONCLUSIONS: The electrophoretic procedure holds promise as a convenient method for the rapid preparation of high-quality spermatozoa for assisted conception purposes. (+info)
(5/76) Single blastocyst transfer after ICSI from ejaculate spermatozoa, percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE).
PURPOSE: To investigate the outcome of IVF following intracytoplasmic sperm injection (ICSI) from ejaculate, percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE), with subsequent blastocyst culture and single blastocyst transfer. METHODS: Single blastocyst transfer was performed after ejaculate ICSI (oligozoospermia) in 587 patients, TESE/PESA (azoospermia) in 31 patients, and standard IVF in 680 women. RESULTS: There were only minor differences in IVF characteristics between the standard IVF and the PESA-TESE couples. Couples where ejaculate ICSI were performed seemed to represent a slightly poorer prognostic group. A viable fetus after the 12th gestational week, i.e. ongoing pregnancy, was present in 41.4% after ICSI/ET, 51.6% after PESA-TESE/ET and in 40.4% after standard IVF/ET (no significant differences). CONCLUSION: Single blastocyst transfer after ejaculate ICSI or after PESA/TESE appears to give similar results as conventional IVF blastocyst culture. (+info)
(6/76) Intracytoplasmic sperm injection (ICSI) in 2006: evidence and evolution.
The introduction of intracytoplasmic sperm injection (ICSI) in 1992 has dramatically changed the management of severe male infertility. In severe male infertility, live birth rates with ICSI are superior to those with other non-donor treatments. In non-male infertility, however, pregnancy rates are not better with ICSI than with in vitro fertilization (IVF). With obstructive or non-obstructive azoospermia, reasonable pregnancy rates are now possible with ICSI after recovery of sperm from the testes followed by ICSI. Genetic counselling is indicated for severe male infertility, whether or not ICSI is considered. ICSI is indicated in preimplantation genetic diagnosis (PGD) to avoid contamination by extraneous DNA in the case of PCR-based testing and to increase the number of embryos available for testing. In turn, PGD may be indicated in pregnancies that are at high risk of aneuploidy because of genetic factors associated with azoospermia. As with IVF, not all couples succeed, but 2% of couples with failed ICSI cycles will conceive without treatment. ICSI outcome studies indicate that there is a significant increase in prematurity, low birthweight, and perinatal mortality associated with single and multiple births, similar to the outcomes of conventional IVF. However, as evidenced in long-term follow-up studies, the higher rates of urogenital abnormalities and increased use of healthcare may be associated with paternal characteristics. (+info)
(7/76) Azoospermic HIV-1 infected patients wishing to have children: proposed strategy to reduce HIV-1 transmission risk during sperm retrieval and intracytoplasmic sperm injection: Case Report.
BACKGROUND: To date, assisted reproductive technology (ART) with sperm washing is offered to serodiscordant couples with an human immunodeficiency virus-1 (HIV-1) infected male partner in order to have a child while reducing the risk of transmission to the woman. However, ART programmes are not possible if the man is azoospermic. We report here the first birth following intracytoplasmic sperm injection (ICSI) using frozen epididymal spermatozoa obtained after surgical sperm retrieval in a HIV-1 infected man with obstructive azoospermia. METHODS; Sperm obtained by micro-epididymal sperm aspiration was frozen after density gradient preparation and tested for HIV-RNA and DNA. ICSI with frozen sperm was performed. RESULTS: A twin pregnancy was obtained following ICSI. Two healthy girls were born. Maternal HIV-1 RNA and HIV-1 serology were negative during pregnancy and at delivery. CONCLUSIONS: This case report demonstrates that ART is possible in azoospermic HIV-1 infected men. On the basis of current knowledge, we propose a strategy to reduce HIV-1 transmission risk during sperm retrieval and ICSI in couples where the man is HIV-1 infected and azoospermic. (+info)
(8/76) Outcome of repeated micro-surgical testicular sperm extraction in patients with non-obstructive azoospermia.
AIM: To evaluate the outcome of repetitive micro-surgical testicular sperm extraction (mTESE) attempts in non-obstructive azoospermia (NOA) cases, in relation to patients' initial testicular histology results. METHODS: A total of 68 patients with NOA in whom mTESE had been performed in previous intracytoplasmic sperm injection (ICSI) attempts were reviewed. RESULTS: Among the 68 patients with NOA, the first mTESE yielded mature sperm for ICSI in 44 (64%) (Sp(+)), and failed in the remaining 24 (36%) (Sp(-)). Following their first trial, 24 patients decided to undergo a second mTESE. Of these 24 patients, no spermatozoa were obtained in 5 patients, and Sp(+) but no fertilization/pregnancy were achieved in 19. In these 24 cases, mTESE was successively repeated for two (n = 24), three (n = 4) and four (n = 1) times. The second attempt yielded mature sperm in 3/5 patients from the Sp- group and 16/19 patients from the Sp(+) group. At the third and fourth trials, 4/4 and 1/1 of the original Sp(+) patients were Sp(+) again, respectively. Distribution of main testicular histology included Sertoli cell-only syndrome (16%), maturation arrest (22%), hypospermatogenesis (21%) and focal spermatogenesis (41%). Overall, in repetitive mTESE, 24/29 (82%) of the attempts were finally Sp(+). CONCLUSION: Repeated mTESE in patients with NOA is a feasible option, yielding considerably high sperm recovery rate. In patients with NOA, mTESE may safely be repeated one or more times to increase sperm retrieval rate, as well as to increase the chance of retrieving fresh spermatozoa to enable ICSI. (+info)