592 THE JOURNAL OF UROLOGY® Vol. 179, No. 4, Supplement, Wednesday, May 21, 2008

(69%), infection (22%), iatrogenic (5%), trauma (1%) and idiopathic (3%). Median duration of obstruction was 18.7 yrs. Previous failed attempts at reconstruction were found in 38% of patients. Mean follow-up period was 16.3 (1-29) months. Overall patency (> 10,000 sperm/ml) rate was 92% (66/72). Early patency was achieved in 73% (41/56) of cases at 4-6 weeks post-operatively. Median best sperm count was 12.9 (0.01-24) x 106/ml with a 23 (0-48)% forward motility. The late “shut-down” rate in this cohort was 4% (2/49) at 1 year post-op. Among patients with follow-up over 1 year, the natural pregnancy rate was 31% (11/36). Median time to achieve natural pregnancy was 15.3 (3-33) months. Pregnancy was achieved with IVF/ICSI in an additional 39% (23/59) of cases, all using fresh ejaculated sperm.

CONCLUSIONS: Currently, LIVE is our procedure of choice for all cases of vasoepididymostomy. A high patency rate with a reasonable natural pregnancy rate was achieved using LIVE. Even when assisted reproductive technology is needed, fresh ejaculated sperm can be used without requiring a subsequent sperm retrieval procedure. Our clinical experience supports LIVE as an effective reconstruction approach male for epididymal obstruction with natural pregnancy rates competitive with primary IVF/ICSI.

Source of Funding: Canadian Institutes of HealthResearch.

1728ORCHIDOPEXY IN ADULTHOOD IMPROVE MALE FERTILITYMohamed N Mhiri*, Hichem Jallouli, Mahdi Bouassida, Mohamed Gassara, Ahmed Sahnoun, Hammadi Fakhfakh, Ali Bahloul. Sfax, Tunisia.

INTRODUCTION AND OBJECTIVE: Undescended testis (UT) is a frequent congenital disease which is often diagnosed and treated during childhood. Untreated cryptorchidism until puberty may lead to male infertility. The aims of this study are to asses how orchidopexy at adulthood could improve, in some extent semen parameters and chances of procreation.

METHODS: A cohort of 33 infertile men with UT underwent orchidopexy in our institution. No other associated causes of infertility were found in all patients. Mean patients age was 31,2 years ( 24 - 35 years). UT was bilateral in 36,4 % of the cases and unilateral in 63,6 %.

ml. Preoperative semen analysis showed severe to mild oligo-astheno-

RESULTS: After orchidopexy, motile sperm was obtained in

of 1,6.106

from 9,4 to 14,7×106 6.Moreover, spontaneous pregnancy was achieved in 4 couples (12 %) after a mean follow-up of 13 months (7 to 22 months).

CONCLUSIONS: Surgical correction of UT at adulthood can improve semen quality and increase the rate of paternity. However, late orchidopexy does not prevent subsequent testicular cancer.

Source of Funding: None

1729THE EFFECT OF VARICOCELE REPAIR ON SEMEN REACTIVE OXYGEN SPECIES ACTIVITY IN INFERTILE MENMohit Khera*, Bobby B Najari, Joseph P Alukal, Osama Mohamed, Ethan D Grober, Wesley Ekeruo, Larry I Lipshultz. Houston, TX.

INTRODUCTION AND OBJECTIVE: Varicocele is the leading cause of infertility in the world and is present in almost 40% of infertile men. Recent data suggests that oxidative stress is a cause of sperm dysfunction in varicocele patients. While semen reactive oxygen species (ROS) activity has been correlated with varicocele grade, there is very limited data on the effects of varicocele repair on semen ROS activity in infertile men.

METHODS: We conducted a retrospective review of patient charts from 2001 to 2007. All infertile male patients that had undergone a varicocele repair and who had a semen analysis with ROS performed before and after the surgery were included in the study. Additionally, ROS activity before surgery was compared to ROS activity in all

infertile patients that did not have varicocele repair, as well as all fertile patients that had undergone a vasectomy reversal. Semen analyses and quantitative ROS activity before and after varicocele repair were compared by a rank sum test. ROS test result status was compared by chi squared analysis. ROS activity in the different populations was compared by ANOVA on ranks.

RESULTS: The median and interquartile ranges for ROSactivities of the 2,224 infertile men without a varicocele, and the 17 men that had undergone a vasectomy reversal, were 2 (1-5) and 1.3

undergone a varicocele repair with a median ROS activity before surgery of 3.65 (2-10.8). The differences in ROS activity among the 3

2 months before surgery (range 0-20). Postoperative semen analysis were performed a median of 6 months after varicocele repair (range 3-50). Quantitative ROS activity decreased from a median of 3.65 before surgery to a median of 2.00 after surgery (p=0.036).

CONCLUSIONS: Varicoceles significantly impair fertility

reduced ROS activity in the seminal plasma of infertile males, but not to the level of fertile males.

Source of Funding: None

1730THE USE OF SPERM BOUND TO THE OOCYTE ZONA PELLUCIDA FOR INTRACYTOPLASMIC SPERM INJECTION: PRELIMINARY RESULTSAssumpto Iaconelli, Debora Rodrigues, Daniela Braga, Rita Figueira, Tatiana C S Bonetti, Fabio F Pasqualotto, Edson Borges*. Sao Paulo, Brazil, and Caxias do Sul, Brazil.

INTRODUCTION AND OBJECTIVE: In infertile men, a small in

vitro and there is a relationship between normal sperm morphology in

functional sperm. The present study evaluated the use of sperm bound

METHODS: This pilot study included 8 ICSI cycles in which women were 31.4 ± 3.07 y-old. For each patient, mature oocytes were

5µL of sperm sample (concentration: 2 x106/mL) for 2 h. After incubation,

and high quality embryos rates were compared between the groups.

a logistic regression analysis was conducted.

(80.5 vs p=0.302),

bound sperm was injected (79.0 vsrespectively, p= 0.212). In addition, the logistic regression analysis

p=0.207).

represents a sperm population satisfying a necessary condition for

these characteristics are associated with paternal effects in embryo development is still unclear. The present study evaluated the usefulness

Source of Funding: None