In Vitro Retrieval of Epididymal Sperm: An Analysis of 11 Years of Cumulative Data

Purpose: To evaluate the efficacy of in vitroretrieval of epididymal sperm for the induction of pregnancy in patients with post-testicular causes of infertility, and assess the sperm distribution within the epididymis of these patients. Materials and Methods: Analyses of the sperm count and motility of sperm retrieved from the detached epididymis, and of the resulting fertilization and pregnancy outcomes were conducted. A total 62 infertile couples, due to post-testicular male causes, had sperm retrieved from the epididymis. The sperm count and motility, as well as the fertilization and pregnancy rates, were measured. Results: Epididymal sperm was retrieved from 60 males with post-tes-ticular infertility. The average sperm concentration and motility of the sperm after sperm preparation were 43.0x106/ml and 25%, respectively. The clinical pregnancy rate per cycle was 57.9 % (11/19) with in vitro fer-tilization (IVF), 39.0 % (16/41) with intracytoplasmic sperm injection (ICSI) using fresh epididymal sperm, and 42.9 % (27/63) with ICSI using frozen epididymal sperm. Conclusions: The in vitro retrieval of epididymal sperm is recommended as a simple and effective method to obtain viable sperm from infertile patients with obstructive azoospermia or sperm excretion disorders. (Korean J Urol 2007;48:843-848