In recent years, the range of assisted reproductive technologies has expanded significantly, and many couples with infertility, even with its severe forms, were able to have their own children. 272 married couples with male infertility factor -azoospermia who underwent TESA in the period from January 2016 to July 2020 were examined. It was shown that in 73% of patients with azoospermia it was possible to obtain sperm. Clinical pregnancy occurred in 47% of this category of patients, but 17% of them had a miscarriage. In 33% of patients, pregnancy did not occur, in 9% of patients did not have normal embryos. It was shown that during the repeated TESA procedure in 89% of patients in whom sperm were found for the first time sperm were also found. In 8% of patients with repeated TESA procedure, no sperm were found. in patients with a negative result of the procedure TESA and in the future no sperm was found. It is shown that the negative result of the procedure TESA cannot be explained by age-related changes in the male body, since most of the men in this category were under the age of 40 years.

The basis of the mechanism of cilia and sperm flagella motility is the sliding of doublets of microtubules relative to each other due to translational movement of dyneins. Previously, external and internal dynein arm were considered similar in structure and functions, however, recent experimental data suggest a significant difference in the composition of subunits, axoneme location, and regulatory mechanisms. And although the understanding of the principles of changes in the activity of the described motor proteins remains incomplete, subtle mechanisms of the functioning of these structures have been established.

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