Related Experiment Video
Updated: Jun 29, 2026
Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
Efficacy of percutaneous needle aspiration and open biopsy for sperm retrieval in men with non-obstructive
Juul Houwen1, Kersti Lundin, Brita Söderlund
1Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, the Netherlands.
Objective:
To assess the efficacy of the two most common sperm retrieval procedures, testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) as part of the diagnostic work-up in men with non-obstructive azoospermia. Design. Retrospective cohort study.
Setting:
Center for Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Sample:
Three hundred fifty men who underwent diagnostic surgical sperm recovery between January 1997 and December 2006.
Methods:
A diagnostic TESA was initially performed in 281 men with testes of >12 mm(3). If no spermatozoa or an insufficient number of spermatozoa was found, most of the men underwent a diagnostic TESE. Diagnostic TESE was performed as the only surgical procedure in 69 men who had at least one testis < or =12 mm(3).
Main Outcome Measures:
Success rates of diagnostic TESA and diagnostic TESE.
Results:
Spermatozoa were found in 129 (45.9%) of the 281 men who underwent TESA. However, in 29 of these men too few spermatozoa were identified for the men to be accepted for IVF/ICSI. The subsequent TESE resulted in 26 additional men being accepted for IVF/ICSI. In men with testes < or =12 mm(3) a sufficient number of spermatozoa were found in 27 out of 69 men following TESE.
Conclusions:
The study shows that in 52% of the men with non-obstructive azoospermia spermatozoa useful for ICSI can be identified. For at least one-third of the men with testes >12 mm(3) TESA is a sufficient procedure. Sperm retrieval rate is further increased following a subsequent TESE.
