1. Outcome of Surgical Sperm Retrieval (SSR) followed by ICSI in men with obstructive azoospermia University of Aberdeen Assisted reproductive unit D.Giannaris, S.Bhattacharya, M.Hamilton

2. Obstructive azoospermia Typical features Vasectomy and failed reversal surgery CAVD Other cases - Normal karyotype - Normal FSH (<14) - Normal testicular biopsy - Testicular size

3. STUDY GROUPS Group A: Failed reversal vasectomy (n=83) Group B: CAVD (n=16) Group C: Obstruction of other causes (n=33) 12 patients with non-obstructive azoospermia

4. 4 S.S.R results Total No n Sperm Retrieved n % Group A n=83 100% Group B n=16 n=15 94% Group C n=33 n=29 88%

5. Total Motile Sperm Retrieved Motile sperm (Median ( M)) * * (p = 0.002)

6. Number of straws prepared Mean no of straws (p = 0.001)

7. No of follicles aspirated in IVF No of follicles (NS)

8. Nos. of eggs obtained at IVF Mean nos of eggs (NS)

9. Nos. of eggs fertilised Eggs fertilised (NS)

10. Fertilisation rate at IVF % eggs fertilised (NS)

11. Nos. of embryos transferred Embryos transferred (NS)

12. Implantation Rate % Sacs/ Embryos transferred (NS)

13. Live births & ongoing pregnancies % per cycle started (NS)

14. Patient & treatment profiles (Pregnant vs Non-pregnant) No differences in: embryos grade embryos stage male age female age 1y vs 2y female infertility male smoking female smoking Statistical significant difference in: female pathology

15. Conclusions S.S.R is effective in obstructive azoospermia. Failed vasectomy reversal group have the best prognosis. Cases other than vasectomy reversal or CAVD were associated with fewer motile sperm, lower implantation rate and lower live birth rate. Few numbers to demonstrate statistical significance.