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Chapter 8 - Sperm Retrieval in Non-azoospermic Men

Indications, Protocol, and Outcomes

from Part II - Sperm Retrieval

Published online by Cambridge University Press:  09 April 2021

By
Sandro C. Esteves  and
Ahmad Majzoub
Edited by
Ashok Agarwal ,
Ahmad Majzoub  and
Sandro C. Esteves
Ashok Agarwal
Affiliation:
The Cleveland Clinic Foundation, Cleveland, OH, USA
Ahmad Majzoub
Affiliation:
Hamad Medical Corporation, Doha, Qatar
Sandro C. Esteves
Affiliation:
Andrology & Human Reproduction Clinic, Sao Paulo, Brazil
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Summary

Sperm retrieval and intracytoplasmic sperm injection (ICSI) has become the natural treatment for couples with azoospermia-related infertility, and nowadays is also used for nonazoospermic indications. An increasing body of evidence overwhelmingly based on cohort studies has indicated that ICSI with ejaculated sperm of poor quality negatively affects the chances of assisted conception. Collectively, these data suggest that ICSI with testicular sperm is superior to ICSI with ejaculated sperm as a method of fertilization to overcome sperm DNA fragmentation-related infertility. The candidates are men with high sperm DNA damage in semen and those with severe oligozoospermia or cryptozoospermia. In these patients, percutaneous and open sperm retrieval are highly successful to harvest sperm, with few complications. Current evidence suggests the safe utilization of testicular sperm for ICSI in nonazoospermic men. Further research is warranted to confirm the clinical utility of this approach as a routine ART treatment.

Keywords

sperm DNA fragmentationsperm chromatin damagesperm retrievaltesticular spermejaculated spermassisted reproductive technologyin vitro fertilizationintracytoplasmic sperm injectionoligozoospermiacryptozoospermiapregnancyoffspring healthmale infertility
Type
Chapter
Information
Manual of Sperm Retrieval and Preparation in Human Assisted Reproduction , pp. 56 - 74
Publisher: Cambridge University Press
Print publication year: 2021

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