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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.


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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. 

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Center for Male Reproductive Medicine & Microsurgery Weill Cornell Medicine
525 E 68th Street
New York, NY 10065