Sexual Function/Infertility Reproductive Potential of Men with Obstructive Azoospermia Undergoing Percutaneous Sperm Retrieval and Intracytoplasmic Sperm Injection According to the Cause of Obstruction

Accepted for publication June 22, 2012. Study received institutional review board approval. * Correspondence: Androfert, Andrology and Human Reproduction Clinic, Center for Male Reproduction, Av. Dr. Heitor Penteado, 1464, Campinas, São Paulo 13075-460, Brazil (telephone: 55 19 3295-8877; FAX: 55 19 3294-6992; e-mail: [email protected]). Purpose: We evaluated the retrieval rates and reproductive outcomes of percutaneous sperm retrieval according to the cause of obstructive azoospermia. Materials and Methods: We retrospectively studied the records of 146 men with obstructive azoospermia who underwent sperm retrieval for intracytoplasmic sperm injection. Patients were grouped by the cause of obstruction, including 32 with congenital bilateral absence of the vas deferens, 59 with vasectomy and 55 with obstruction due to post-infection disease. Sperm were retrieved percutaneously from the epididymis or testis. We compared retrieval rates and intracytoplasmic sperm injection outcomes, including neonatal results, in the groups of men with obstructive azoospermia. Results: The success of sperm retrieval was similar among the etiology groups, including 100% for congenital bilateral absence of the vas deferens, 96.6% for vasectomy and 96.3% for previous infection. Significantly fewer men in the congenital bilateral absence of the vas deferens group needed testicular aspiration compared to those in the post-infection and vasectomy groups (3.1% vs 23.6% and 30.5%, respectively, p 0.001). Sperm cryopreservation was possible in 26.7% of the cases and did not significantly differ among the groups. Live birth rates after sperm injection were similar in the congenital (34.4%), vasectomy (32.2%) and previous infection (36.4%) groups. Birth parameters, prematurity and low birth weight rates were comparable among the groups. Conclusions: Percutaneous sperm retrieval is an effective method to retrieve sperm in men with obstructive azoospermia irrespective of the cause of obstruction. The chance of achieving a live birth and the profile of neonates born after sperm injection do not seem to be related to the cause of obstruction.