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Review
. 2021 Apr;49(4):3000605211002703.
doi: 10.1177/03000605211002703.

Predictors of testicular sperm retrieval in patients with non-obstructive azoospermia: a review

Lin Qi  1   2 , Ya P Liu  1   2 , Nan N Zhang  3 , Ying C Su  1   2
Affiliations
Review

Predictors of testicular sperm retrieval in patients with non-obstructive azoospermia: a review

Lin Qi et al. J Int Med Res. 2021 Apr.

Abstract

Azoospermia is divided into two categories of obstructive azoospermia and non-obstructive azoospermia. Before 1995, couples with a male partner diagnosed with non-obstructive azoospermia had to choose sperm donation or adoption to have a child. Currently, testicular sperm aspiration or micro-dissection testicular sperm extraction combined with intracytoplasmic sperm injection allows patients with non-obstructive azoospermia to have biological offspring. The sperm retrieval rate is significantly higher in micro-dissection testicular sperm extraction compared with testicular sperm aspiration. Additionally, micro-dissection testicular sperm extraction has the advantages of minimal invasion, safety, limited disruption of testicular function, a low risk of postoperative intratesticular bleeding, and low serum testosterone concentrations. Failed micro-dissection testicular sperm extraction has significant emotional and financial implications on the involved couples. Testicular sperm aspiration and micro-dissection testicular sperm extraction have the possibility of failure. Therefore, predicting the sperm retrieval rate before surgery is important. This narrative review summarizes the existing data on testicular sperm aspiration and micro-dissection testicular sperm extraction to identify the possible factor(s) that can predict the presence of sperm to guide clinical practice. The predictors of surgical sperm retrieval in patients with non-obstructive azoospermia have been widely studied, but there is no consensus.

Keywords: Sperm retrieval rate; infertility; intracytoplasmic sperm injection; micro-dissection testicular sperm extraction; non-obstructive azoospermia; testicular sperm aspiration.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Preoperative consultation and examination guide for selection of surgical methods. TESA, testicular sperm aspiration; MD-TESE, micro-dissection testicular sperm extraction; ICSI, intracytoplasmic sperm injection.
Figure 2.
Figure 2.
Regulation of spermatogenesis.
See this image and copyright information in PMC

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