ABSTRACT
Background: The male infertility accounts for approximately 40%-50%, in which the cases without sperms in semen occupy nearly 5% for Obstructive Azoospermia (OA). Percutaneous Epididymal Sperm Aspiration (PESA) in combination with serum FSH (Follicle Stimulating Hormone) test was effective in the diagnosis and treatment of this disease. Objectives: To evaluate preliminarily the results of the technique of PESA in the diagnosis of OA and in combination with intracytoplasmic sperm injection (ICSI) for treating male infertility. Subjects and method: A longitudinal, interventional study was carried out on 110 cases of male infertility treated at the Assisted Reproductive Technology Center of National Hospital of Obstetrics and Gynecology from August 7th 2005 to July 30th 2006. All patients underwent PESA and then testicular fine needle aspiration (TEFNA) if necessary. Results: The mean age of patients was 34.75+/-6.68 years. Among 110 patients, 54 cases (49.1%) had post-operative diagnoses of OA, 56 cases (50.9%) were diagnosed with complete azoospermia after PESA and TEFNA procedures. There were correlations between the volume of left and right testis and the probability of sperms in testing samples (p= 0.03 and =0.05, respectively). Also, serum FSH concentration related to the positive result of sperm test (p< 0.0001). Conclusion: PESA is less-invasive and exact method to the diagnosis of azoospermia. It should be done PESA for patients with testis volume >=10ml and serum FSH concentration <20mIU/mL.