Reply by the Authors

Abstract

Men with congenital bilateral absence of vas deferens are successfully treated with surgical sperm aspiration and in vitro fertilization/intracytoplasmic sperm injection. In the article by Lee et al, 1 Lee J.Y. Dada R. Sabanegh E. et al. Role of genetics in azoospermia. Urology. 2011; 77: 598-601 Abstract Full Text Full Text PDF PubMed Scopus (78) Google Scholar we suggested testicular sperm aspiration for sperm retrieval because sperm isolated from the testis have better genomic integrity compared with spermatozoa stored in the epididymis. 2 Steel E.K. McClure N. Maxwell R.J. et al. Comparison of DNA damage in testicular and proximal epididymal spermatozoa in obstructive azoospermia. Mol Hum Report. 1999; 5: 831-835 Crossref PubMed Scopus (109) Google Scholar , 3 Dozortsev D. Neme R. Diamond M.P. et al. Embryos generated using testicular spermatozoa have higher developmental potential than those obtained using epididymal spermatozoa in men with obstructive azoospermia. Fertil Steril. 2006; 86: 606-611 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar Dozortsev et al 3 Dozortsev D. Neme R. Diamond M.P. et al. Embryos generated using testicular spermatozoa have higher developmental potential than those obtained using epididymal spermatozoa in men with obstructive azoospermia. Fertil Steril. 2006; 86: 606-611 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar reported that in cases with obstructive azoospermia, embryos generated using testicular sperm had higher developmental potential compared with those obtained using epididymal spermatozoa. However, we also agree that percutaneous sperm aspiration (PESA) and microsurgical epididymal sperm aspiration can be used with higher success in sperm harvesting and can yield higher sperm concentration. 4 Dohle G.R. Ramos L. Pieters M.H. et al. Surgical sperm retrieval and intracytoplasmic sperm injection as treatment of obstructive azoospermia. Hum Reprod. 1998; 13: 620-623 Crossref PubMed Scopus (56) Google Scholar , 5 Bromage S.J. Falconer D.A. Lieberman B.A. et al. Sperm retrieval rates in subgroups of primary azoospermic males. Eur Urol. 2007; 51: 534-540 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar Re: Lee et al.: Role of Genetics in Azoospermia (Urology 2011;77:598-601)UrologyVol. 78Issue 6PreviewWe have with great interest read the review by Lee et al published recently regarding the role of genetics in azoospermia. We are disappointed that only testicular sperm extraction (TESE) was suggested as the method of sperm retrieval in patients with congenital bilateral absence of the vas deferens (CBAVD).1 In our experience, percutaneous sperm aspiration (PESA) is less invasive and is associated with a higher success in sperm harvesting for intracytoplasmic sperm injection. Moreover, the sperm density is significantly higher when compared with TESE. Full-Text PDF