Sperm retrieval for use with the advanced form of assisted reproduction, ICSI, is now possible for many men with non-obstructive azoospermia. Men with NOA may have unique genetic defects that should be evaluated prior to an attempt at conception. At New York Hospital-Cornell, 58% of couples have sperm retrieved from the testis with TESE, and 55% of couples achieve a clinical pregnancy using sperm retrieved with TESE, using the advanced reproductive technique of ICSI. Since some couples will not have sperm retrieved with TESE, the potential use of back-up frozen donor spermatozoa should be discussed with couples prior to simultaneous TESE-ICSI attempts.
1. Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus H, Van Steirteghem A, Silber S. Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod 10:1457-1460, 1995.
2. Jaffe T, Oates RD. Genetic abnormalities and reproductive failure. Urol Clin No Am 21:389-408, 1994.
Kahraman S, Ozgur S, Alatas C, Aksoy S, Tasdemir M, Nuhoglu A, et al. Fertility with testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermic men. Hum Reprod 11:756-760, 1996.
3. Novero V, Goossens A, Tournaye H, Silber S, Van Steirteghem AC, Devroey P: Seminoma discovered in two males undergoing successful testicular sperm extraction for intracytoplasmic sperm injection. Fertil Steril 65:1051-4, 1996.
4. Palermo GD, Schlegel PN, Colombero LT, Zaninovic N, Moy F, Rosenwaks Z. Aggressive sperm immobilization in ICSI using epididymal and testicular spermatozoa improves fertilization and pregnancy rates. Hum Reprod 11:1023-1029, 1996.
5. Palermo GD, Schlegel PN, Sills ES, Menendez S, Veeck LL, Rosenwaks Z. Births following testicular sperm used with intracytoplasmic sperm injection in non-mosaic Klinefelter's syndrome. N Engl J Med 338:588-590, 1998.
6. Schlegel PN. Su L-M. Physiologic consequences of testicular sperm extraction. Hum Reprod 12:1688-1692, 1997.
7. Schlegel PN, Girardi SK: Clinical review: In vitro fertilization for male factor infertility. J Clin Endocrinol Metab, 82:709-716, 1997.
8. Schlegel PN, Palermo GD, Goldstein M, Menendez S, Zaninovic N, Veeck LL, Rosenwaks Z. Testicular sperm extraction with ICSI for non-obstructive azoospermia. Urology, 49:435-440, 1997.
9. Tesarik J, Rolet F, Brami C, Sedbon E, Thorel J, Tibi C, Thebault A. Spermatid injection into human oocytes. II. Clinical application in the treatment of infertility due to non-obstructive azoospermia. Hum Reprod 11:780-783, 1996.