[Several techniques can help men with testicular azoospermia to become biological fathers]

Men with testicular azoospermia (NOA) have impaired spermatogenesis, and surgical testicular procedures are required to retrieve sperm. If testicular sperm can be retrieved, men with NOA can become biological fathers via intracytoplasmic sperm injection (ICSI). Several techniques are available today, such as needle aspiration (TESA), percutaneous biopsies and open biopsies (conventional TESE/micro-TESE). The most recent technique is micro-TESE, a non-blind technique, where seminiferous tubules with the highest probability of containing sperm are selected using an operative microscope. Though clinical routines differ between fertility centres where micro-TESE is available, sperm recovery rates are high. Similar risk for adverse outcomes have been observed in offspring compared with standard IVF. New non-blind sperm recovery techniques, such as micro-TESE, are encouraging and may improve sperm retrieval outcome in men with NOA. However, they require surgical and embryologist skills as well as investment in an operative microscope.