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Related Concept Videos

Infertility in Males01:23

Infertility in Males

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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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Sperm Transport01:15

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The journey of sperm from its origin to the point of ejaculation begins within the seminiferous tubules of the testis. Here, Sertoli cells produce fluid that propels non-motile sperm through a series of conduits, starting with the straight tubules leading to the rete testis. This interconnected network of tubules acts as the initial pathway for sperm, guiding them into the efferent ductules and then into the epididymis for maturation.
The maturation phase occurs in the epididymis, where sperm...
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Related Experiment Video

Updated: Feb 23, 2026

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
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A step-by-step guide to office-based sperm retrieval for obstructive azoospermia.

Robert M Coward1,2, Jesse N Mills3

  • 1Department of Urology, UNC School of Medicine, Chapel Hill, NC, USA.

Translational Andrology and Urology
|September 15, 2017
PubMed
Summary

Surgical sperm retrieval for obstructive azoospermia (OA) offers multiple safe, office-based options. A new technique, minimally invasive epididymal sperm aspiration (MIESA), provides millions of motile sperm for cryopreservation.

Keywords:
MESAMIESAObstructive azoospermia (OA)PESATESATESEepididymal spermsperm retrievaltesticular sperm

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Area of Science:

  • Urology
  • Reproductive Medicine
  • Surgical Techniques

Background:

  • Obstructive azoospermia (OA) presents challenges for male fertility.
  • Various surgical sperm retrieval techniques exist, including percutaneous and open approaches.

Purpose of the Study:

  • To review existing sperm retrieval techniques for obstructive azoospermia.
  • To introduce and describe a novel minimally invasive epididymal sperm aspiration (MIESA) technique.
  • To provide a comprehensive guide for male reproductive surgeons.

Main Methods:

  • Review of established percutaneous (PESA, TESA) and open (TESE, MESA) sperm retrieval methods.
  • Detailed description of the new MIESA technique, emphasizing its minimally invasive nature.
  • Discussion of preoperative evaluation, patient selection, procedural steps, and complication management.

Main Results:

  • Established techniques like PESA, TESA, TESE, and MESA are effective for sperm retrieval.
  • The MIESA technique is presented as a safe, office-based procedure yielding millions of motile sperm.
  • High sperm retrieval rates are achievable with current assisted reproductive technologies.

Conclusions:

  • Obstructive azoospermia is no longer an insurmountable barrier to biological fatherhood.
  • Multiple surgical options, including the novel MIESA, offer effective sperm retrieval.
  • Comprehensive surgical guidance ensures successful outcomes for male factor infertility.