The success of repeated microdissection sperm retrieval (M-TESE) and intracytoplasmic sperm injection (ICSI) following a conventional testicular biopsy in men with nonobstructive azoospermia

Sperm retrieval includes essential procedures in the treatment and management of male factor infertility. Appropriate diagnostic investigation is necessary to correctly identify the etiology of azoospermia among obstructive, nonobstructive (defective spermatogenesis), and aspermia. In this chapter, we discuss the necessary work-up of an individual presenting with azoospermia along with the relevant medical and surgical management to optimize success with surgical sperm retrieval. This review contains 7 figures, 2 tables, and 68 references. Key Words: anejaculation, azoospermia, MESA, microTESE, nonobstructive azoospermia, obstructive azoospermia, PESA, TESE, testicular biopsy

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Sperm Retrieval and Intracytoplasmic Sperm Injection in Men With Nonobstructive Azoospermia, and Treated and Untreated Varicocele

The Journal of Urology ◽

10.1016/j.juro.2009.06.028 ◽

2009 ◽

Vol 182 (4) ◽

pp. 1500-1505 ◽

Cited By ~ 71

Author(s):

Kubilay Inci ◽

Metin Hascicek ◽

Onder Kara ◽

Ayse Veyhurda Dikmen ◽

Timur Gürgan ◽

...

Keyword(s):

Intracytoplasmic Sperm Injection ◽

Nonobstructive Azoospermia ◽

Sperm Retrieval

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Techniques for sperm recovery in assisted reproduction

Reproductive Medicine Review ◽

10.1017/s0962279999000253 ◽

1999 ◽

Vol 7 (2) ◽

pp. 131-139 ◽

Cited By ~ 3

Author(s):

Sarah K Girardi ◽

Peter N Schlegel

Keyword(s):

Assisted Reproduction ◽

Testicular Biopsy ◽

Surgical Reconstruction ◽

Significant Heterogeneity ◽

Obstructive Azoospermia ◽

Donor Insemination ◽

Nonobstructive Azoospermia ◽

Sperm Retrieval ◽

Donor Sperm ◽

Sperm Aspiration

During the past decade, few fields in medicine have changed as dramatically as reproductive medicine and the treatment of male infertility. Whereas previously only men with obstructive azoospermia were candidates for treatment, either through surgical reconstruction or sperm aspiration, now even men with nonobstructive azoospermia are able to achieve pregnancies without having to resort to donor sperm. The extraordinary success of assisted reproduction after sperm retrieval for azoospermic men is the result of three important discoveries. First is the clinical observation that epididymal transit of sperm is not required for successful fertilization. Second is the recognition that significant heterogeneity in testicular biopsy specimens exists. Lastly is the advent of intracytoplasmic sperm injection (ICSI), which has enabled fertilization regardless of the degree of sperm impairment or retrieval source as long as sperm are viable. These three discoveries have enabled fertilizations and pregnancies for men previously referred for donor insemination or adoption, and have therefore broadened the indications for sperm retrieval. This review is intended to describe in detail the available techniques for the recovery of sperm, with emphasis on the latest technique, testicular microdissection for sperm retrieval in nonobstructive azoospermia.

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Faculty Opinions recommendation of Sperm retrieval and intracytoplasmic sperm injection in men with nonobstructive azoospermia, and treated and untreated varicocele.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1168248.630401 ◽

2009 ◽

Author(s):

Cigdem Tanrikut

Keyword(s):

Intracytoplasmic Sperm Injection ◽

Nonobstructive Azoospermia ◽

Sperm Retrieval

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Optical coherence tomography: a novel modality for scrotal imaging

Canadian Urological Association Journal ◽

10.5489/cuaj.1128 ◽

2013 ◽

Vol 3 (4) ◽

pp. 319 ◽

Cited By ~ 5

Author(s):

Cole Davis ◽

Wayne Kuang

Keyword(s):

Optical Coherence Tomography ◽

Testicular Biopsy ◽

Prise En Charge ◽

Optical Coherence ◽

Nonobstructive Azoospermia ◽

Sperm Retrieval ◽

Tomographic Images ◽

Conventional Histology ◽

Scrotal Imaging ◽

Tubule Diameter

Background: For patients with nonobstructive azoospermia,sperm retrieval rates remain modest. We describe the use ofoptical coherence tomography to improve retrieval rates and todecrease tissue destruction.Methods: Four patients underwent diagnostic testicular biopsyand imaging with the Niris optical coherence tomography de -vice. We performed a descriptive comparison between optic alcoherence tomographic images and conventional histology.Results: The measured seminiferous tubule diameter differed by16 μm between comparative imaging from optical coherencetomography and conventional histology using hematoxylin andeosin staining.Conclusion: We illustrate the usefulness of optical coherencetomography in the setting of testicular biopsy and the managementof nonobstructive azoospermia.Contexte : Chez les patients atteints d'azoospermie non obstructive,les taux de collecte de spermatozoïdes demeurent modestes.Nous décrivons le recours à une tomographie optiquecohérente pour améliorer les taux de collecte et réduire ladestruction tissulaire.Méthodes : Quatre patients ont subi une biopsie testiculaire diagnostiqueet une épreuve d'imagerie à l'aide d'un appareil Nirisde tomographie optique cohérente. Une comparaison descriptivea été effectuée entre les images obtenues par tomographieoptique cohérente et les résultats des épreuves histologiquesstandard.Résultats : La différence dans le diamètre des tubules séminifèresmesuré par tomographie optique cohérente et par coloration histologiqueà l'hématoxyline-éosine n'était que de 16 μm.Conclusion : Nous présentons une étude descriptive illustrant l’uti -lité de la tomographie optique cohérente pendant une biopsietesticulaire en vue de la prise en charge d'une azoospermie nonobstructive.

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