TESE for Cryptozoospermia with Normal Sperm DNA Fragmentation

  • Ahmad H. Al-Malki
  • Armand Zini


Sperm DNA fragmentation has been associated with abnormal semen parameters and poor reproductive outcomes. To overcome the effect of sperm DNA damage on reproduction, several investigators advocate the use of testicular rather than ejaculated sperm for intracytoplasmic sperm injection (ICSI). In men with cryptozoospermia (variant of nonobstructive azoospermia), sperm DNA fragmentation testing is not feasible (due to the very low number of spermatozoa), although sperm DNA damage is likely present in the spermatozoa of these men. As such, the use of testicular sperm for ICSI has been proposed as a treatment for these couples. However, the data to support this approach are limited and conflicting. Therefore, clinicians are encouraged to rely on their own judgment in deciding on whether to proceed to testicular sperm retrieval-ICSI or ejaculated sperm-ICSI with a careful understanding of the potential risks associated with the use of testicular sperm.


Testicular sperm Sperm retrieval ICSI Male infertility Sperm DNA Severe OAT Cryptozoospermia TESE 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ahmad H. Al-Malki
    • 1
  • Armand Zini
    • 1
    • 2
  1. 1.Division of Urology, Department of SurgeryMcGill UniversityMontrealCanada
  2. 2.Department of Obstetrics and GynecologyUniversity of MontrealMontrealCanada

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