Beyond IUI, IVF and ICSI - New developments in - eshre 2013

Sperm density – Sperm Concentration - some facts
Ideal semen volume and sperm density are achieved after
2-3 days abstinence period
Shorter abstinence periods decrease sperm density
Tyler et al., 1982; Nnatu et al. 1991
Longer abstinence periods increase sperm density, but also
increases the proportion of dead, immotile or morphologically
abnormal sperm
Pellestor et al, 1994
The highest concentration of sperm is in the initial portion of the
ejaculate
Daily practice to solve unexpected azoospermia –
Albeit the different knowledge in the literature
1. Repeated Ejaculation.
especially in the cryptozoospermia group, a
repeated ejaculation may produce better quality of
ejaculate.
In our experience, p about 30% will have better qquality y
in their repeated sperm sample than in the first one.
2. Immediate TESE if no sperm is present , also not in the
repeated ejaculate
Since 2007 we had 8 patients with no visible sperm in their first
and second ESP on which urgent TESE was performed.
Sperm was found in 4 of them.
In a study where 3 cases were taken to Urgent TESE only in one of
them sperm were detected.
Song SH et al., 2010
Meaning,
Urgent TESE is not a treatment with which sperm presence is
guarantied, also not in crypto azoospermia.
,
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