MESA (Microsurgical Epididymal Spasm Aspiration) and 'in vitro' fertilization (IVF) in patients with azoospermia due to differential epididymal obstruction: Preliminary experience [MESA (MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION) E FERTILIZZAZIONE IN VITRO (IVF) IN PAZIENTI CON AZOOSPERMIA DA OSTRUZIONE EPIDIDIMO-DEFERENZIALE: ESPERIENZA PRELIMINARE]

Microsurgical Epididymal Sperm Aspiration (MESA) has been reported as a new and effective form of treatment for azoospermia due to Congenital Absence of the Vas deferens (CAV). This report concerns two men with azoospermia due to Epididymal Obstruction (EO), submitted to MESA procedure in an attempt to achieve In Vitro Fertilization (IVF) of their wives' oocytes. In the first case, a large number of spermatozoa with 'poor motility' were retrieved and in only one of 4 oocytes was the formulation of 2 pronuclea observed. In the second case, no spermatozoa and only one oocyte was retrieved. Although pregnancy was not obtained, data confirm that the flow of sperm through the epididymis is not mandatory for sperm maturation and fertilization.