Author/Editor		Smrkolj, Tomaž; Virant-Klun, Irma; Šinkovec, Jasna; Oblak, Ciril; Zorn, Branko
Title		Epididymovasostomy as the first-line treatment of obstructive azoospermia in young couples with normal spermatogenesis
Type		članek
Source		Reprod Biomed Online
Vol. and No.		Letnik 20, št. 5
Publication year		2010
Volume		str. 594-601
Language		eng
Abstract		In the management of obstructive azoospermia (OA), microsurgery is often replaced by testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI). Testicular biopsy and microsurgical side-to-side epididymovasostomy were performed in 34 azoospermic men with OA mostly due to inflammation. Ductal system patency was recovered in 21 (63.6%) men and natural pregnancy achieved in 13 (38.2%) of couples. Using multiple logistic regression analysis, it was found that ductal system patency and pregnancy were influenced by male and female age and testicular histology. The chance of obtaining patency was three times higher when male age was <38years and two times higher when normal spermatogenesis alone was found to be present compared with mixed lesions. The chance of achieving a pregnancy was three times higher when the female partner's age was <29years or normal spermatogenesis alone was present. The pregnancy rates obtained after surgery were not statistically different from those obtained by TESE-ICSI, but when also considering multiple pregnancies, miscarriages and side effects, the results obtained with surgery are better than those obtained with TESE-ICSI.
Descriptors		INFERTILITY, MALE SPERMATOGENESIS OLIGOSPERMIA EPIDIDYMITIS VASOVASOSTOMY MICROSURGERY TESTIS BIOPSY SEMINIFEROUS TUBULES