J Korean Androl Soc.  1997 Jun;15(1):59-64.

Efficacy of Intracytoplasmic Sperm Injection (ICSI) using Epididymal and Testicular Sperm for Failed Vasoepididymostomy and Vasovasostomy

• Kim YC
• Kim JH
• Seo JT
• Jin JY
• Chung YH
• Lee YS

Abstract

PURPOSE: In cases of failed vasoepididymostomy and vasovasostomy, there is no absolute confidence in the success of a repeat anastomosis operation. We evaluated the efficacy of intracytoplasmic sperm injection (ICSI) with microsurgical epididmal sperm aspiration (MESA) and testicular sperm extraction (TESE) as supportive procedures for repeat vasoepididymostomy and vasovasostomy.
METHODS
Reanastomosis was attempted simultaneously with MESA-ICSI or TESE-ICSI in 39 patients who had had a history not failed vasoepididymostomy (n=30) or failed vasovasostomy (n=9).
RESULTS
Reanastomosis was possible simultaneously with MESA in 10 of 30 patients with the history of failure of the previous vasoepididymostomy. Three patients showed anatomic success. Reanastomosis proved impossible in the remaining 20 patients, of whom 11 patients underwent MESA and 9 had TESE. Reanastomosis was possible simultaneously with TESE in 7 of the 9 patients with the failure on previous vasovasostomy, and 6 patients showed anatomic success. The remaining 2 patients underwent TESE. Fertilization and embryo transfer were done successfully in all 39 patients. Fifteen women (38%) are either having a normal pregnancy or have undergone normal delivery.
CONCLUSION
MESA-ICSI and TESE-ICSI are good supportive procedures to compensate for the low success rate of repeat vasoepididymostomy and vasovasotomy.

MeSH Terms

Embryo Transfer
Female
Fertilization
Humans
Infertility
Pregnancy
Sperm Injections, Intracytoplasmic*
Sperm Retrieval
Spermatozoa*
Vasovasostomy*