Sperm Retrieval Surgery

Sperm retrieval is most commonly performed for azoospermic men. Azoospermia may be the result of severely impaired sperm production (azoospermia due to spermatogenic dysfunction) or normal sperm production in the setting of physical blockage of sperm transport (obstructive azoospermia). Although microsurgical reconstruction is possible for many men with obstructive azoospermia, some couples will still elect sperm retrieval with use of assisted reproductive technology (ART), including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). ART allows men who have surgically retrieved sperm to contribute to pregnancies, even when limited numbers of viable sperm are available and even if sperm have not matured by proceeding through the entire male reproductive system. The management of men with obstructive azoospermia and of those with azoospermia due to spermatogenic dysfunction is markedly different. Not only does the genetic/diagnostic testing vary for these two conditions, but also the management and outcomes take different directions.