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52 - The Management of Azoospermia

from PART III - ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

By
S. Friedler ,
A. Raziel ,
D. Strassburger ,
M. Schachter ,
O. Bern ,
E. Kasterstein ,
D. Komarovsky  and
R. Ron-El
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

The ability to treat azoospermic men to become genetic fathers of children represents one of the most dramatic revolutions that have occurred in the field of infertility treatment during the past two decades. Use of donor sperm is no longer the first and only treatment option in these cases. The discovery that one may use a single sperm cell and achieve normal embryos, pregnancy, and delivery after assisted fertilization by intracytoplasmic sperm injection (ICSI) changed many of the previous axiomas in the field of andrology (Palermo et al., 1992; Van Steirteghem et al., 1993). For men with no sperm in the ejaculate, surgical retrieval of sperm cells from the epididymis or testicular seminiferous tubules in combination with ICSI opened new avenues for fulfilling their fatherhood.

DEVELOPMENT OF METHODS FOR SURGICAL SPERM RETRIEVAL (SSR)

The first to be treated were patients with obstructive azoospermia (OA), where viable spermatozoa were retrieved from the testis with testicular sperm extraction (TESE) or testicular biopsy and used for ICSI (Craft et al., 1993; Schoysman et al., 1993a, b; Devroey et al., 1994; Nagy et al., 1995; Abuzeid et al., 1995; Silber et al., 1995a, b, c; Tucker et al., 1995) or epididymal sperm retrieval by an open surgery aimed at the epididymis named microepididymal sperm aspiration (MESA) (Temple-Smith et al., 1985; Silber et al., 1994; Tournaye et al., 1994).

Keywords

azoospermiamicroepididymal sperm aspirationpercutaneous epididymal sperm aspirationpost-testicular azoospermiatesticular azoospermiatesticular fine-needle aspirationtesticular sperm extractionpretesticular azoospermia
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 478 - 492
Publisher: Cambridge University Press
Print publication year: 2008

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