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  • Title: The use of epididymal spermatozoa in assisted reproduction.
    Author: McLachlan RI.
    Journal: J Reprod Fertil Suppl; 1998; 53():277-84. PubMed ID: 10645287.
    Abstract:
    The use of epididymal spermatozoa in assisted reproduction (ART) permits fertility in men with surgically irremediable obstructive azoospermia. When used for conventional IVF (sperm-oocyte co-culture), epididymal spermatozoa show reduced fertilization and pregnancy rates (compared with ejaculated spermatozoa from men with a range of spermatogenic disorders) as evidence of their functional immaturity. However, when used with intracytoplasmic sperm injection (ICSI) either fresh or frozen-thawed epididymal spermatozoa produce ART success rates similar to those of ejaculated spermatozoa. The clinical place of epididymal sperm retrieval for ICSI has come under review as a result of data showing similarly good outcomes with testicular spermatozoa obtained by needle aspiration. In Australia ICSI using epididymal or testicular spermatozoa is an increasingly favoured option for vasectomy-related infertility and in other types of obstructive azoospermia for a number of reasons including better pregnancy outcomes, the less invasive nature of the procedures and less expense involved; however, this cost-benefit analysis will vary in other health systems.
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