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Related Concept Videos

Infertility in Males01:23

Infertility in Males

Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...

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Personalized Management of Non-Obstructive Azoospermia: Current Evidence, Clinical Strategies, and Future Directions.

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Related Experiment Video

Updated: May 31, 2026

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
06:28

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Published on: May 27, 2022

Surgical sperm retrieval: Techniques and their indications.

Rupin Shah1

  • 1Department of Urology, Lilavati Hospital and Research Centre, Bandra Reclamation, Mumbai, India.

Indian Journal of Urology : IJU : Journal of the Urological Society of India
|July 1, 2011
PubMed
Summary

Men with azoospermia can achieve fatherhood via sperm retrieval techniques. This review details methods like percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE) for successful sperm retrieval.

Keywords:
Azoospermiaepididymalsperm retrievaltesticular

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Area of Science:

  • Reproductive Medicine
  • Urology
  • Andrology

Background:

  • Azoospermia, the absence of sperm in ejaculate, affects male fertility.
  • Intra-cytoplasmic sperm injection (ICSI) enables fatherhood for men with azoospermia if sperm can be retrieved.
  • Various surgical sperm retrieval techniques exist, each with specific indications and success rates.

Purpose of the Study:

  • To review and discuss the different surgical sperm retrieval methods available for men with azoospermia.
  • To outline the merits and indications for each technique, guiding clinical decision-making.
  • To emphasize a stepwise approach, starting with the least invasive procedures.

Main Methods:

  • Review of percutaneous and open surgical procedures for sperm retrieval.
  • Discussion of techniques including percutaneous epididymal sperm aspiration (PESA), needle aspiration biopsy (NAB), and testicular sperm extraction (TESE).
  • Comparison of open microsurgical biopsy techniques: single seminiferous tubule (SST) and microdissection TESE.

Main Results:

  • For obstructive azoospermia, PESA is often successful; NAB may be used if PESA fails.
  • For non-obstructive azoospermia, testicular sperm retrieval is necessary, with NAB as a potential first step.
  • Microdissection TESE and SST offer options for retrieving testicular sperm when less invasive methods fail.

Conclusions:

  • Sperm retrieval from the epididymis or testis allows men with azoospermia to father a child via ICSI.
  • The choice of technique depends on the type of azoospermia (obstructive vs. non-obstructive).
  • A hierarchical approach, beginning with the simplest, least invasive sperm retrieval method, is recommended.