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Micro-testicular Sperm Extraction

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Male Infertility

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Abstract

The condition of nonobstructive azoospermia (NOA) defines men with testicular failure who have severely deficient sperm production with no sperm in the ejaculate. NOA is the underlying diagnosis in approximately 10% of men seeking fertility evaluation. On testicular biopsy, these patients demonstrate hypospermatogenesis, maturation arrest, or Sertoli cell-only pattern (germinal cell aplasia). NOA may be related to genetic causes, as in Klinefelter syndrome (KS) and XX-male syndrome, or may be acquired, as in testicular failure secondary to cryptorchidism or systemic chemotherapy administration. As recently as two decade ago, techniques were not available to assist patients with NOA conceive offspring and their options were limited to donor spermatazoa or child adoption. A remarkable series of four distinct advancements have dramatically advanced the field in recent years, and today it is possible even for men with Sertoli cell-only pattern to initiate pregnancy with medical assistance. In this chapter, we focus on considerations and techniques related to microscopic testicular sperm extraction (microdissection TESE). Microdissection TESE, a technique developed at New York-Presbyterian Hospital–Weill Cornell Medical Center, yields superior sperm retrieval rates and requires a minimal amount of testicular tissue compared with other methods of sperm extraction.

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Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, 435, New York, 10065, NY, USA

    Doron Sol Stember MD

  2. Department of Urology, Weill Cornell Medical College, New York-Presbyterian/Weill Cornell Hospital, 525 East 6th Street, Starr 900, New York, 10065, NY, USA

    Peter Schlegel MD

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  1. Doron Sol Stember MD
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  2. Peter Schlegel MD
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Correspondence to Doron Sol Stember MD .

Editor information

Editors and Affiliations

  1. University of Florida, Director, Robotic Surgery, Winter Haven Hospital &, 200 Avenue F. N.E., Winter Haven, 33881, Florida, USA

    Sijo J. Parekattil

  2. Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Ashok Agarwal

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Stember, D.S., Schlegel, P. (2012). Micro-testicular Sperm Extraction. In: Parekattil, S., Agarwal, A. (eds) Male Infertility. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3335-4_39

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  • DOI: https://doi.org/10.1007/978-1-4614-3335-4_39

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  • Print ISBN: 978-1-4614-3334-7

  • Online ISBN: 978-1-4614-3335-4

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