RESUMEN
In case requiring microsurgical epididymal sperm aspiration(MESA) for congenital absence of the vas deferens or unreconstructable obstructive azoospermia, spermatozoa sometimes could not be retrieved from the epididymis or were necro and teratozoospermia. We studied whether testicular biopsy sperm extraction (TESE) in such cases could yield spermatozoa that would result in successful fertilization and pregnancy using intracytoplasmic sperm injection(ICSI) from November, 1994 to April, 1995. Thirty cycles were treated with TESE-ICSI. The mean age of husbands was 34 years(range 25 to 42 years). A total of 426 oocytes were collected and 333 were subsequently microinjected. Normal fertilization occurred in 234 oocytes(70.3%). Thirty cases underwent embryo transfer, with a total of 176 embryos(75.2%) transferred. Twelve cases conceived with a clinical pregnancy rate of 40. O% per transfer and all of whom are ongoing normal pregnancy. Conclusively, when epididymal spermatozoa can not be retrieved TESE Would be final resort that is also very effective with most patients obtaining high fertilization and pregnancy rates. It appears that all cases of obstructive azoospermia can now be successfully treated.