Integrating artificial intelligence in surgical sperm retrieval techniques: A narrative review

Abstract

Nonobstructive azoospermia (NOA) is a serious form of male infertility with therapeutic options limited to trials of endocrine manipulations and repertoire of surgical interventions, also known as surgical sperm retrieval (SSR) procedures. Despite its invasive nature, SSR remains crucial in the management of NOA, offering infertile males the opportunity of fathering their biological children using assisted reproductive technologies. Success rates of SSR are variably governed by several factors including the genetic background, preoperative endocrine optimization, testicular histopathology, surgeon's microsurgical expertise, and laboratory technological and technical team's capability. This paper explores the significant role of artificial intelligence (AI) in the process of sperm retrieval among NOA patients. The role of AI has evolved from basic predictive models used for outcome assessment and patient counseling, to advanced image processing capabilities for assessing sperm parameters, and now to cutting-edge applications in identifying the rare sperm present in the azoospermic microdissection testicular sperm extraction tissue samples.