Sperm Retrieval in Non-Azoospermic Patients with Intact Ejaculation: A Narrative Review

Although existing research on sperm retrieval predominantly focuses on azoospermic patients, assisted reproductive technology (ART) candidates without azoospermia may still face challenges during oocyte retrieval. Notably, approximately 10% of men with normal sexual function undergoing routine ART insemination experience transient ejaculatory failure during the ART cycle. This failure results in unsuccessful sperm retrieval, thereby disrupting standard treatment protocols. In this narrative review we strive to evaluate the efficacy of sperm retrieval combined with intracytoplasmic sperm injection in managing patients with intact ejaculation and difficulties in semen retrieval. In non‑azoospermic ART candidates, timely sperm retrieval and structured management of transient ejaculatory failure or semen collection difficulties are essential to optimize intracytoplasmic sperm injection (ICSI) outcomes and should be incorporated into standardized protocols.