"A
Year Which Declared Almost an End to Male Factor Infertility"
Congresses 1995 in Vienna, Hamburg and Montpellier
 Those
on the infertility congress trail in 1995 had a bumper year to enjoy, with
three international meetings on the agenda as well as the usual schedule
of local fertility meetings. Indeed, the American meeting, now organized
under the society's new name of the American Society of Reproductive Medicine,
attracted more than 10,000 delegates from a truly international roster.
The conference year began early enough with the IXth World Congresses on
In Vitro Fertilization and Assisted Reproduction held in Vienna during the
first week of April. Less than three months later, between 28 June and 1
July, the annual meeting of the European Society of Human Reproduction and
Embryology (ESHRE) took place in Hamburg. And between 1 7 and 22 September,
the International Federation of Fertility Societies (IFFS) staged its three-yearly
World Congress on Fertility and Sterility, this year in the French city
of Montpellier.
As has become the norm in the most recent congress years on infertility,
the pace of progress was furious. Back in April, the ebullient American
Dr Sherman Silber reported his collaborative work in male factor infertility
with the Brussels group of Devroey and Van Steirteghem. To a meagre audience
in the main auditorium in Vienna, he proposed that there are very few sterile
men who cannot now father their own children. "It's a fascinating new
field," proclaimed Dr Silber, who reminded his audience that, just
a couple of years ago, such men would have had only donor insemination or
adoption to turn to.
 By
the time of Montpellier, the number of groups presenting data on testicular
sperm extraction (TESE) and ICS or microepididymal sperm aspiration (MESA)
and ICSI according to the posters and free communications on offer, was
growing exponentially.
Dr Silber's revealing claim in Vienna was that overall results in severe
male factor cases were not affected by the location of any obstruction
or even whether the patient's azoospermia was obstructive or not. Non-obstructive
cases were equally amenable to treatment. The variables, he explained,
were as in conventional IVF - most importantly the age of the female partner.
Thus, the aspiration techniques used in conjunction with ICSI removed
the entire male factor variable - at least in the hands of the Brussels
group. "It doesn't matter," said Dr Silber, "how severe
the azoospermia or from where the sperm cells are retrieved. The only
issue that can interfere with success is the age of the wife."
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