Obstructive azoospermia: a microsurgical success story

Abstract

Microsurgical techniques used in the treatment of male factor infertility have provided a revolutionary adjunct to the advent of intracytoplasmic sperm injection used in conjunction with in vitro fertilization. Previously infertile couples may now parent their own biological children and, in some cases, may even conceive naturally owing to technical advances within the past decade. This article outlines the modern methods currently employed to address vasal and epididymal obstruction with special emphasis on the importance of microsurgical techniques. The multiple reconstructive and sperm aspiration techniques at our disposal for treatment of vasal and epididymal obstruction as well as the management of ejaculatory duct obstruction are reviewed. The various procedures discussed allow reproductive urologists to maximize male fertility potential in the era of assisted reproductive technologies.