The Very Odd Rapamycin Tale

0 [0.1]; P? http://www.selleckchem.com/products/Rapamycin.html Kingdom; ?Greenslopes Private Hospital, Brisbane, Australia Introduction:?Azoospermia occurs in 1% of men and in 10�C15% of the infertile male population. An obstructive aetiology is found in approximately 40% of azoospermic men. Of these, 30�C67% have obstruction at the level of the epididymis. This study looks at the outcome of microsurgical epididymovasostomy http://www.selleck.cn/products/Bleomycin-sulfate.html in the management of obstructive azoospermia, specifically the patency and pregnancy rates after reconstruction. Patients and Methods:?The outcome of the microsurgical epididymovasostomy procedures performed between 2000�C2011 was retrospectively analysed. Azoospermic patients with normal testicular size, with or without epididymal dilatation, with a normal hormone profile (FSH, LH, and Testosterone), normal male reproductive genetic profile (XY), and a TRUS showing no evidence of ejaculatory duct obstruction, underwent scrotal exploration. An intraoperative vasogram was performed to exclude distal obstruction. Scrotal exploration was performed in 124 patients. The abscence of distal obstruction and the presence of sperm in the epididymal tubules was seen in 91 patients; these patients underwent microscopic epididymovasostomy. The mean patient age for this group was 42 years old (range 27�C62). Microsurgical epididymo-vasostomy was performed using the standard technique in 73%, the intussusception technique in 26%, and a combination of both techniques in 1% of patients. A bilateral epididymovasostomy was performed in 36% of the 91 patients (n?=?29). Results:?Of the 91 reconstructed patients, 4 patients were lost to follow up during the initial assessment period. The patency rate in the remaining 87 patients was 54% (n?=?47). Of the patent group, 26 patients http://www.selleckchem.com/products/MG132.html were followed up to assess pregnancy rates. For these patients, the natural pregnancy rate after 2 years was 27% (n?=?7). With the addition of IVF using sperm from the ejaculate, the overall pregnancy rate was 38% (n?=?10). The outcome was not significantly affected by the side of anastomosis, whether the reconstruction was unilateral or bilateral, the epididymal site of anastomosis (head vs. body vs. tail), or the microsurgical technique used (standard vs. 2 point intussusception). However, the presence of motile sperm in the epididymis positively affected post-operative patency. Of all aetiologies, the post-vasectomy reconstruction was associated with a higher patency rate.