Predictive Factors of Repeat Sperm Aspiration Success
Received 25 September 2008; accepted 11 February 2009. published online 20 November 2009.
Objectives
To evaluate the outcomes of repeated testicular sperm aspirations (TESAs) and to investigate whether the interval between TESA procedures, success in the first attempt, and patient age might influence the results.
Methods
The patient population in the present study consisted of couples undergoing TESA for intracytoplasmic sperm injection. Of these, 189, 46, 42, and 19 male patients underwent 1, 2, 3, and 4 sperm retrievals, respectively. The effects of the interval between TESA procedures, success of the previous attempts, and patient age on sperm recuperation in a repeated procedure were evaluated.
Results
Of the patients with nonobstructive azoospermia from whom sperm was not retrieved in the first procedure, 16.6% had successful sperm retrieval at the second procedure. In 57.1% of the patients who did not achieve sperm recuperation for the second attempt, sperm could be retrieved in the third procedure. Finally, of the patients without success in the third attempt, 40.0% had successful sperm retrieval at the fourth attempt. Success in the preceding TESA procedure positively influenced the success of sperm retrieval in a repeated attempt, and a trend for a negative effect of paternal age in the success of a repeated TESA attempt was noted. However, the interval between procedures had no influence on TESA success.
Conclusions
The results of our study have shown that patient age and the success of the first TESA may predict the results of additional attempts. However, TESA may result in sperm recovery even when the first recovery procedure was not successful. Moreover, sperm recovery did not seem to be affected by the interval between procedures.
aFertility-Assisted Fertilization Center, São Paulo, São Paulo, Brazil
bSapientiae Institute, Educational and Research Center in Assisted Reproduction, São Paulo, São Paulo, Brazil
cInstitute of Biotechnology, Caxias do Sul University, Caxias do Sul, Rio Grande do Sul, Brazil
Reprint requests: Edson Borges Jr., M.D., Ph.D., Fertility-Assisted Fertilization Center, Avenida Brigadeiro Luis Antônio, São Paulo, SP 01401-002 Brazil
ABSTRACT