Le prelevement de sperme deferentiel couple a une Fecondation In Vitro dans les troubles de l’ejaculation

Surgical recovery of spermatozoa from the vas deferens is a simple and reproductible treatment for men with ejaculatory failure. After washing on a Percoll gradient spermatozoa can be used for in vitro fertilization (IVF). Also, when sperm recovery is good, surplus spermatozoa may be frozen. The indications for this treatment include retrograde ejaculation and anejaculation after classic treatments have failed and after failed vasovasostomy. During a one year period five patients were treated in this way (three with retrograde ejaculation and two with anejaculation). The five IVF attemps were performed with aspirates containing 30 to 55 × 106 spermatozoa/ml (mean=42 × 10⁶/ml), 25 to 55% motile spermatozoa (mean=43%). An average of 8.4 ovocytes were inseminated (range=8 to 21) with a fertilization rate of 67% and a success rate of 80% (one term pregnancy, two third trimester pregnancies and one second trimester pregnancy). Surgical sperm aspiration from the vas deferens in cases of ejaculatory failure is a simple, efficacious method by which sufficient mature spermatozoa for an IVF attempt (and/or cryopreservation) can be obtained