An update on sperm retrieval techniques for azoospermic males

Abstract

The use of non-ejaculated sperm coupled with intracytoplasmic sperm injection has become a globally established procedure for couples with azoospermic male partners who wish to have biological offspring. Surgical methods have been developed to retrieve spermatozoa from the epididymides and the testes of such patients. This article reviews the methods currently available for sperm acquisition in azoospermia, with a particular focus on the perioperative, anesthetic and technical aspects of these procedures. A critical analysis of the advantages and disadvantages of these sperm retrieval methods is provided, including the authors' methods of choice and anesthesia preferences.

Comparison of sperm retrieval and reproductive outcome in azoospermic men with testicular failure and obstructive azoospermia treated for infertility

“…If we failed to retrieve sperm by micro-TESE in one testis, the method was used contra-laterally in the same operation. We performed retrievals on an outpatient basis under local anesthesia combined with intravenous propofol infusion 1718. The extracted testicular fragments were immediately examined in the in vitro fertilization (IVF) laboratory 19.…”

Comparison of reproductive outcome in oligozoospermic men with high sperm DNA fragmentation undergoing intracytoplasmic sperm injection with ejaculated and testicular sperm

“…The choice between the two methods was based purely on surgeon preference. All procedures were carried out under local anesthesia combined with an IV bolus infusion of propofol on an outpatient basis (24). The extracted testicular tissue was flushed into a tube containing sperm medium.…”

Testicular histology may predict the successful sperm retrieval in patients with non-obstructive azoospermia undergoing conventional TESE: a diagnostic accuracy study

“…While sperm retrieval rates (SRR) for men with obstructive azoospermia are excellent (96-100 %), the reported overall SRR for patients with nonobstructive azoospermia (NOA) ranges from 30 to 60 % [3]; therefore, identifying those clinical parameters that may reliably predict the chance of retrieving viable sperm in individual NOA patients would be crucial for assisting surgeons and clinicians in the correct counseling of such patients.…”