Surgical management of nonobstructive azoospermia
Tiseo, Bruno Camargo
Hayden, Russell Paul
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CitationTiseo, Bruno Camargo, Russell Paul Hayden, and Cigdem Tanrikut. 2015. “Surgical management of nonobstructive azoospermia.” Asian Journal of Urology 2 (2): 85-91. doi:10.1016/j.ajur.2015.04.020. http://dx.doi.org/10.1016/j.ajur.2015.04.020.
AbstractNonobstructive azoospermia (NOA) is characterized by the complete absence of sperm in the ejaculate due to testicular failure. The evaluation and management of patients with NOA offer a challenge to the reproductive urologist. In the era of in vitro fertilization with intracytoplasmic sperm injection, surgical sperm extraction techniques can afford men with NOA biologic paternity. To provide a comprehensive review of surgical sperm retrieval approaches in the patient with NOA emphasizing complications, success rates and outcome optimization, a Medline search was conducted querying surgical approaches used to manage NOA. Four sperm extraction techniques are described including: testicular sperm aspiration, testicular sperm extraction, fine needle aspiration mapping and microdissection testicular sperm extraction. In addition, the roles for pre-extraction varicocelectomy and sperm cryopreservation are discussed. The management of NOA continues to evolve as newer tools become available. Several modalities of sperm acquisition exist. An understanding of their complications and success rates is fundamental to the treatment of NOA.
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