A 25 year old married male presents with infeility. He had undergone retroperitoneal lymphnode disection at age of 15 years for embryonal carcinoma of right testis. Semen analysis shows-quantity-0.5 ml, no. sperm, no fructose. Biopsy of testis shows normal spermato genesis. Best treatment here would be ?

Ans. is 'c' i.e., Microtesticular Aspiration and intra-cytoplasmic injection Absence of sperms in presence of normal spermatogenesis along with absence of fructose is suggestive of an obstruction in the ejaculatory duct (as described in previous chapter - Prostate & seminal vesicles) "Sperm aspiration techniques are indicated in men in whom the transpo of sperm is not possible because the ductal system is absent or surgically unreconstructable. Aspiration procedures can involve microsurgery to collect sperm from the sperm reservoirs within the genital tract (vas deferens, epididymis or testicle)" - Smith's Urology 17/e, p 710 Microtesticular aspiration of sperm with In Vitro Feilization can help this couple to achieve pregnancy. (Intracytoplasmic injection is a form of IVF)