Abstract
Objective: In recent years, testicular sperm biopsy (TESE), testicular sperm aspiration (TESA) and epididymal sperm have all been used successfully in conjunction with IVF for patients with azoospermia. TESE/TESA specimens require less surgical expertise to obtain than epididymal specimens and can be provided by all staff urologists, thus allowing for greater flexibility in scheduling IVF procedures. Overall, fertilization and ongoing pregnancy rates have tended to be higher with epididymal sperm as compared with testicular sperm. The reasons for this difference are unknown, but may be due to greater difficulty in isolating a clean preparation of motile testicular sperm due to the presence of many different cell types in testicular tissue. These cell contaminants increase the interval for sperm pick-up compared with epididymal aspirates. The purpose of this study was to develop a simple method of processing testicular tissue that would provide a clean preparation of motile sperm and allow sperm pick-up for ICSI with the same relative ease as with epididymal aspirates. Fertilization and pregnancy rates obtained with this new method (TESE-N) were compared with those from Percutaneous Epididymal Sperm Aspiration (PESA) and a previous TESE technique (TESE-P).
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