Epididymal sperm aspiration and use of donor spermatozoa when necessary for in-vitro fertilization, and vasoepididymostomy: an acceptable combination in the treatment of obstructive azoospermia.

Infertility due to obstructive azoospermia in 24 men was treated with a combination of scrotal exploration, microsurgical sperm aspiration and vasoepididymostomy, at the same operation. In-vitro fertilization (IVF) and embryo transfer were performed using epididymal spermatozoa. Donor spermatozoa were used if no motile epididymal spermatozoa were obtained. With this combination, emotionally and economically acceptable pregnancy rates were achieved: 24% per aspiration, 43% per embryo transfer, and 25% per couple. One twin pregnancy resulting in the birth of two healthy female infants and one ongoing twin pregnancy were achieved with epididymal spermatozoa; four pregnancies (one twin, two singletons, one abortion) were achieved with donor spermatozoa.