Pregnancy Following in Vitro Fertilization and Embryo Transfer by Microsurgical Epididymal Sperm Aspiration from a Patient with Congenital Absence of the Vas Deferens--a Case Report
Resource
CHINESE MEDICAL JOURNAL v.57 n.2 pp.161-164
Journal
CHINESE MEDICAL JOURNAL
Journal Volume
v.57
Journal Issue
n.2
Pages
161-164
Date Issued
1996
Date
1996
Author(s)
TZENG, CHII-RUCY
HSIAO, SEN-YUAN
CHIEN, LI-WEI
CHANG, SHU-JU
CHIANG, HAN-SUN
WU, CHIEN-CHIH
CHEN, AN-CHIUN
Abstract
Congenital absence of the vas deferens (CAVD) had been considered a virtually untreatable cause of male infertility . Men with this condition have been shown on testicular biopsy to have adequate spermatogenesis, and are theoretically producing sperm capable of fertilizing an oocyte. Yet epididymal transit was thought to be essential for the maturation of spermatozoa and development of their fertilizing ability since the characteristics of sperm motility improve as the sperm passes through the cauda. However recent studies in man have shown that spermatozoa aspirated from the obstructed caput epididymis and ductuli efferentia are, in fact, capable of fertilization in vitro. Microsurgical epididymal sperm aspiration (MESA) from the proximal region (caput) of the epididymis, obtained 0.5x106 sperm per ml, following washing and direct swim up. Twelve oocytes were inseminated and three embryos were generated for transfer. The patient conceived and deliveried a healthy female baby weighting 2838 gm, on March 3, 1994. This is the first documentation in Taiwan of live birth resulting from MESA from a patient with CAVD combined with in vitro fertilization and embryo transfer.