Pregnancy with testicular spermatozoa

Abstract

In a patient with a diagnosis of congenital vas deferens agenesis we decided to carry out a microsurgical epididymal sperm aspiration in order to attempt an in vitro fertilization (IVF). Since during scrotal exploration no epididymus was found (probably as a consequence of a previous surgical biopsy) a testicle biopsy was performed. The latter yielded a few hundred sperms which were injected within the cytoplasm of his wife's oocytes (ICSI technique). Of the 18 oocytes, 3 were harmed during the procedure and 16 hours later signs of normal fertilization were detected in 6 of them, followed by the development of 4 embryos. These were transcervically transferred to the uterus, 3 in 8 cell stage and 1 in 6 cell stage; previously a 20 micron hole had been made with acid Tyrode solution in the pelucida zone of each embryo. Fifteen days later, the result of the HCG beta subunit assay was positive and a month later a single 19 mm normal embryo was detected by ultrasound echography.