Indications of sperm retrieval with invasive techniques

Indications of sperm retrieval with invasive techniques

1. Azoospermia cases
2. Obstructive azoospermia

Surgical correction of obstruction may be tried in obstructive azoospermia cases if it is amenable to treatment. Epididymovasostomy, vazovasostomy operations for proximal obstructions and transurethral ejaculatory duct resection or transrectal aspiration of prostatic cysts can be performed. If the patient is not amenable to surgery or in the case of failure of surgery ; MESA ,PESA or TESA/TESE can be performed to obtain sperm

-Nonobstructive Azoospermia
In nonobstructive azoospermia cases there is a problem with the sperm production. The problem may be related with hypothalamic-pituitary axis which regulates spermatogenesis within the testis. Microsurgical TESE is preferred in nonobstructive azoospermia cases because of the risk of obtaining insufficient sperm when TESA performed. It is suggested that mapping before TESE/TESA helps to define the possible sites of spermatogenesis. If the etiology of azoospermia is a pure hormonal deficiency, the hormone replacement treatment before TESE has been conclusively demonstrated to be efficacious.