Author information Article notes Copyright and License information Disclaimer. Small soft testes suggest impaired sperm production, while indurated epididymities or absence of palpable vasa deferentia with normal volume testes suggest obstruction. Gentle negative pressure is applied to aspirate the epididymal fluid, which is sent to the laboratory for examination. Moreover, the gross semen characteristics provide important clues about the nature of azoospermia. Continued epididymal exploration and repeat epididymal punctures should be performed until an epididymal site containing microscopically adequate fluid is identified, moving toward the caput of the epididymis with each successive puncture that does not yield sufficient quality epididymal fluid. Another important and relevant question that has been raised is whether or not ICSI outcomes vary based on the use of fresh vs.
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Percutaneous epididymal sperm aspiration
Bacitracin ointment is applied to the incision. Repeated biopsies from one or both testes are obtained until sufficient sperm has been harvested for that IVF cycle. Example wet-mounts of aspirated epididymal fluid are seen in Figures 2a and 2b. Only men with no sperm in their ejaculate azoospermia need to have sperm retrieved directly from the testis or epididymis. The epididymal tubule is sealed with bipolar electrocautery and hemostasis is ensured.