| pubmed-article:9017098 | pubmed:abstractText | The reasons for the discrepancy between 'patency' and 'pregnancy' in the outcome of microsurgical refertilization are partially unknown. The quality of the intra-operative aspirate and of the spermatozoa at the level of the anastomosis are discussed worldwide as important factors influencing the success of fertilization in the case of post-operative patency. In 152 men undergoing microsurgical refertilization (vasovasostomy, tubulovasostomy, microsurgical epididymal sperm aspiration, transurethral resection of the ejaculatory duct), 281 aspirates were classified intra-operatively according to Silber, and post-operatively using the Shorr staining technique. In 62 aspirates a computer-aided sperm analysis (CASA) was performed. The percentage of intact spermatozoa decreased from 94.9% at the caput to 9.4% at the cauda epididymidis. The post-operative classification demonstrated an acceptable correlation (0.71) to all grades of intraoperative classification. There was a good correspondence in Silber 4 and 5 but worse in Silber 1 and 2. In CASA, the percentage of motile spermatozoa was not different between epididymal and post-epididymal aspirates. Furthermore, velocity parameters did not differ significantly, but there was a significantly higher straightness of post-epididymal spermatozoa in comparison to epididymal spermatozoa. | lld:pubmed |
