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Chapter 14 - Obstructive Azoospermia: Is There a Place for Microsurgical Testicular Sperm Extraction?

Published online by Cambridge University Press:  24 May 2020

R. John Aitken
Affiliation:
University of Newcastle, New South Wales
David Mortimer
Affiliation:
Oozoa Biomedical Inc, Vancouver
Gabor Kovacs
Affiliation:
Epworth Healthcare Melbourne
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Summary

Obstructive azoospermia (OA) is a common presenting condition of male infertility, resulting from either congenital or acquired blockage of the reproductive tract. Men facing a diagnosis of OA now have an array of treatment options, including definitive reconstruction and various forms of sperm retrieval. The optimum treatment decision for OA will depend on the goals, values, and expectations of the patient and his partner. In this review we will discuss the therapeutic approach to OA, stressing the requirement of a clear and thoughtful plan for staged intervention. Any proposed treatment strategy should optimize the chances of paternity while minimizing damage to the male genitourinary system. Special attention will be paid to the role of microdissection testicular sperm extraction (microTESE), as it is a useful and often underutilized rescue procedure for OA. Specifically, the advantages and disadvantages of microTESE will be evaluated, with particular focus on success rates and safety.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

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