Paper Information

Title: 

COMPARISON OF PREGNANCY RATES FOLLOWING DIFFERENT METHODS OF SPERM EXTRACTION IN AZOOSPERMIC MEN

Type: PAPER
Author(s): HOSSEINI SEYED JALIL*,SHAFI HAMID,KARIMIAN LEILA
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

INFERTILITY IS ESTIMATED TO OCCUR IN 15% OF COUPLES, WITH A MALE FACTOR BEING INVOLVED IN HALF.10% OF INFERTILE MEN HAVE HAVE AZOOSPERMIC WHICH IS ONE OF THE SURGICALLY TREATABLE CAUSES OF MALE INFERTILITY.
THE OBJECTIVE OF THIS STUDY WAS TO COMPARE PREGNANCY RATES AFTER DIFFERENT METHODS OF SPERM EXTRACTION FROM AZOOSPERMIC MALES: TESTICULAR SPERM EXTRACTION (TESE), MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION (MESA), AND PERCUTANEOUS EPIDIDYMAL SPERM ASPIRATION (PESA).
MATERIALS AND METHODS: 405 COUPLES WERE SELECTED FOR THIS CLINICAL TRIAL. AZOOSPERMIC PATIENTS WITH TESTICULAR ATROPHY AND OR FSH ELEVATION TO ABOVE 3 TIMES THE NORMAL LEVEL WERE EXCLUDED. PATIENTS WITH AZOOSPERMIC ON 3 CONSECUTIVE SEMEN ANALYSES UNDERWENT SPERM EXTRACTION BY PESA, MESA OR TESE. INTRACYTOPLASMIC SPERM INJECTION WAS PERFORMED FOLLOWING SUCCESSFUL SPERM EXTRACTION. THE EMBRYOS WERE TRANSFERRED TO THE UTERUS AFTER 48 HOURS. SERUM BHCG DETERMINATION AFTER 2 WEEKS AND ULTRASOUND AFTER 1 MONTH WERE DONE TO CONFIRM BIOCHEMICAL AND CLINICAL PREGNANCY RESPECTIVELY.
RESULT: MEAN AGE WAS 34 YEARS IN MEN AND 28 YEARS IN WOMEN. MEAN DURATION OF INFERTILITY WAS 8 YEARS.517 CASES OF PESA, 17 CASES OF MESA, AND 278 CASES OF TESE WERE DONE IN 405 MEN. CONCEPTION RATE WAS 68.7%, 69.1%, AND 51.3% RESPECTIVELY. FROM THE 513 TREATMENT CYCLES, 450 EMBROYONAL CYCLES WERE PERFORMED IN THE PATIENTS WIVES. PREGNANCY WAS ACHIEVED IN 55 (18.6%), (9.1%), AND 17 (11.8%), RESPECTIVELY, WITH AN OVERALL PREGNANCY RATE OF 16.2% (73 PATIENTS). THERE WAS NO STATISTICALLY SIGNIFICANT DIFFERENCE IN PREGNANCY RATE BETWEEN THE THREE GROUPS, ALTHOUGH THE TREND OF INCREASING PREGNANCY RATES WAS SIGNIFICANT. DISCUSSION AND CONCLUSION: CONCEPTION AND PREGNANCY RATES ARE HIGHER WITH PESA THAN WITH TESE, WHICH IS COMPATIBLE WITH THE PRESENCE OF CHROMOSOMAL ABNORMALITIES IN NONOBSTRUCTIVE AZOOSPERMIC. PESA IS USED FOR SPERM EXTRACTION IN AZOOSPERMIC MEN, WITH TESE BEING DONE IS PESA FAILS.

 
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