Surgical sperm retrieval for intracytoplasmic sperm injection

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility Treatment

Background:

• Intracytoplasmic sperm injection (ICSI) has revolutionized male infertility treatment.
• Testicular sperm retrieval offers a viable option for severe male factor infertility, including azoospermia.

Purpose of the Study:

• To evaluate the efficacy of testicular sperm retrieval for ICSI in patients with various forms of male infertility.
• To assess the predictive value of testicular biopsy histopathology for sperm recovery.
• To explore the potential of less invasive sperm retrieval techniques and cryopreservation.

Main Methods:

• Sperm retrieval from testicular tissue via biopsy or aspiration.
• Histopathological examination of testicular biopsies.
• Intracytoplasmic sperm injection (ICSI) cycles with preimplantation diagnosis.
• Comparison of different sperm retrieval techniques.

Main Results:

• Testicular spermatozoa can be recovered from most patients with excretory azoospermia and about half with secretory azoospermia.
• Testicular biopsy histopathology is a strong predictor of successful sperm recovery, especially in germ-cell aplasia.
• Successful ICSI cycles resulted in live births, even in patients with Klinefelter syndrome.
• Less invasive techniques like percutaneous fine-needle aspiration show comparable success rates in specific patient groups.

Conclusions:

• Testicular sperm retrieval is effective for treating severe male infertility, offering high fertilization and implantation rates with ICSI.
• Histopathology aids in predicting successful sperm retrieval, guiding treatment strategies.
• Less invasive methods and cryopreservation present promising alternatives, potentially reducing the need for repeated surgical procedures.