Testicular sperm retrieval for assisted reproductive techniques

Abstract

The possibility of achieving a pregnancy with just one spermatozoon has led to the evolution of a number of methods aiming to obtain sperm from testicular tissue. This achievement now offers men with azoospermia a reasonable chance of fathering their own children. The choice of the best testicular sperm retrieval technique has always been a challenge. There has been a trend to use percutaneous needle aspiration but controlled studies have demonstrated that open testicular biopsy is necessary to obtain the best results, particularly in non-obstructive azoospermia. Since azoospermic men are at risk of specific genetic defects, careful genetic testing and counselling prior to treatment should be considered to allow the couple to make an informed decision as to whether or not to use the husband sperm. The recovery of sperm may not always be successful particularly in non-obstructive azoospermic men, an event that encompasses important emotional and financial implications. Unfortunately, no clinical or laboratory test can clearly predict success with sperm retrieval procedures.