Surgical management of nonobstructive azoospermia

Asian Journal of Urology, 2015, 2 (2): 85-91 doi:

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Surgical management of nonobstructive azoospermia

Bruno Camargo Tiseo, Russell Paul Hayden, Cigdem Tanrikut

1. Department of Urology, Massachusetts General Hospital, Boston, MA, USA;
2. Human Reproduction Center (Hospital of Clinics of the School of Medicine of USP), Sao Paulo, Brasil;
3. Harvard Medical School, Boston, MA, USA;
4. MGH Fertility Center, Boston, MA, USA

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Abstract Nonobstructive azoospermia (NOA) is characterized by the complete absence of sperm in the ejaculate due to testicular failure. The evaluation and management of patients with NOA offer a challenge to the reproductive urologist. In the era of in vitro fertilization with intracytoplasmic sperm injection, surgical sperm extraction techniques can afford men with NOA biologic paternity. To provide a comprehensive review of surgical sperm retrieval approaches in the patient with NOA emphasizing complications, success rates and outcome optimization, a Medline search was conducted querying surgical approaches used to manage NOA. Four sperm extraction techniques are described including: testicular sperm aspiration, testicular sperm extraction, fine needle aspiration mapping and microdissection testicular sperm extraction. In addition, the roles for preextraction varicocelectomy and sperm cryopreservation are discussed. The management of NOA continues to evolve as newer tools become available. Several modalities of sperm acquisition exist. An understanding of their complications and success rates is fundamental to the treatment of NOA.

Key words： Nonobstructive azoospermia Surgical management Testicular sperm aspiration Fine needle aspiration

Published: 30 April 2015

Corresponding Authors: Cigdem Tanrikut E-mail: ctanrikut@partners.org

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Bruno Camargo Tiseo,Russell Paul Hayden,Cigdem Tanrikut. Surgical management of nonobstructive azoospermia[J]. Asian Journal of Urology, 2015, 2(2): 85-91.

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http://www.ajurology.com/EN/ OR http://www.ajurology.com/EN/Y2015/V2/I2/85

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