Sperm retrieval techniques in patients with non-obstructive azoospermia


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Abstract

Patients with non-obstructive azoospermia (NOA), which accounts for up to 10-15% of all cases of male infertility, until recently could only become parents using donor sperm or through adoption. Modern technical capabilities of sperm extraction in combination with the use of assisted reproductive technologies, make it possible to effectively overcome infertility in this group of patients. A number of highly effective techniques have been proposed for spermatozoa retrieval. However, surgical intervention is associated with certain risks, and therefore, the choice of the optimal treatment method is under discussion. A total of 52 articles were analyzed using the MEDLINE database (PubMed) to form an overview of the current principles of examination and preparation ofa patient with NOA for the surgical sperm retrieval. This review is dedicated to the role of diagnostic testicular biopsy. In addition, a comparative information on the efficacy and safety of percutaneous, fine-needle aspiration, open multifocal and microdissection (micro-TESE) testicular biopsies is presented. Of the currently available sperm retrieval techniques in the urologic armamentarium, micro-TESE seems to be both the most effective and the safest. Micro-TESE can be a cumbersome procedure, however, it provides successful treatment in situations previously associated with zero chance of pregnancy.

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About the authors

N. D Akhvlediani

A.I. Evdokimov Moscow State University of Medicine and Dentistry; University Clinic “Kuskovo” of A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: nikandro@mail.ru
Ph.D., MD, professor at the Department of Urology Moscow, Russia

I. A Reva

University Clinic “Kuskovo” of A.I. Evdokimov Moscow State University of Medicine and Dentistry

Ph.D., Head of the Urologic Department Moscow, Russia

A. S Chernushenko

University Clinic “Kuskovo” of A.I. Evdokimov Moscow State University of Medicine and Dentistry

urologist at the Urologic Department Moscow, Russia

D. Yu Pushkar

A.I. Evdokimov Moscow State University of Medicine and Dentistry

academician of RAS, Ph.D., MD, professor, Head of the Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Honored Scientist of Russia, Chief urologist of the Ministry of Health of Russia and Moscow Moscow, Russia

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