P. Incze, J. Meriano, K. Jarvi, R. Casper, M. Buckspan
Toronto, Ontario, Canada

Azoospermia secondary to proximal epididymal obstruction near the retetestis or due to maturation arrest will benefit from Assisted Reproductive Technologies. The former can undergo testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI), while the latter can have round spermatids isolated from a testicular biopsy. Using a micromanipulator, the round spermatid nucleus can be extracted from this haploid cell and injected into an oocyte (ROSNI).

Four men with proximal epididymal obstruction underwent TESA and ICSI. Four men with maturation arrest underwent testicular biopsy and were found to have round spermatids which were then used in the ROSNI procedure. All eight men achieved fertilization with a minimum of two zygotes being transferred transvaginally into the uterus of the spouse. The zygote transfer occurred at the four or eight-cell blastocyst stage. At present, one clinical pregnancy has occurred from a patient with proximal epididymal obstruction.