Methods of surgical sperm extraction and implications for assisted reproductive technology success

Intracytoplasmic sperm injection offers a chance to surpass severe forms of male factor infertility, including azoospermia. Retrieval of the male gamete from the epididymis or testis provides the chance for biological parenthood for the affected men. In this review, we scrutinize the recent evidence about the surgical sperm retrieval methods for use in association with ICSI. We provide a historical overview of the surgical sperm retrieval methods development, its indication in both azoospermic and non-azoospermic men, and the technical aspects of each method. We also present and critically discuss the evidence concerning the success of ICSI using non-ejaculated sperm and the consequences of this approach to the health of resulting offspring.