Intratesticular Sperm Extraction

Abstract

In the scenario of medically assisted reproduction, sperm retrieval techniques (SRTs) represent a concrete possibility to find, freeze, and use spermatozoa in men with a diagnosis of azoospermia. Therefore, many infertile couples because of a severe male factor can achieve a biological offspring. Nowadays the surgical overview in this field has a number of available techniques according to the causal and baseline condition. These stretch from the percutaneous approach to the latest and more sophisticated microsurgical dissection techniques aimed at increasing surgical specificity and eventually the sperm retrieval rate in individuals with nonobstructive azoospermia. In this context, the careful and complete diagnostic classification of every patient (obstructive vs. nonobstructive azoospermia) is essential in the choice of the surgical approach (percutaneous vs. open) and the anatomical site of acquisition (epididymis vs. testis), as well as in the prediction of the sperm retrieval successful rate. Although can be considered day-surgery procedures, SRTs are clearly not free from potential sequelae and complications; therefore, it is clinically relevant to have an appropriate surgical indication, a thorough information of the patient and a meticulous perioperative management.