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Sperm Retrieval and Quality Evaluation

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Human Fertility

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1154))

Abstract

Technical refinements in sperm retrieval methods and the application of advanced reproductive technologies (ART) using surgically retrieved sperm have enabled biological paternity in azoospermic men who were considered untreatable 20 years ago. Achievement of optimal reproductive outcomes in these patients benefits greatly from a multistep, interdisciplinary process of sperm acquisition that involves reproductive endocrinologists, urologists, or other specialists in male subfertility, and laboratory personnel with expertise in characterizing and isolating sperm from surgically retrieved specimens. The critical steps in this process are discussed in this chapter.

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References

  1. Kolettis PN, Sabanegh ES (2001) Significant medical pathology discovered during a male infertility evaluation. J Urol 166:178–180

    Article  PubMed  CAS  Google Scholar 

  2. Hotaling JM, Walsh TJ (2009) Male infertility: a risk factor for testicular cancer. Nat Rev Urol 6:550–556

    Article  PubMed  CAS  Google Scholar 

  3. Walsh TJ, Croughan MS, Schembri M et al (2009) Increased risk of testicular germ cell cancer among infertile men. Arch Intern Med 169:351–356

    Article  PubMed Central  PubMed  Google Scholar 

  4. Raman JD, Nobert CF, Goldstein M (2005) Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis. J Urol 174:1819–1822, discussion 1822

    Article  PubMed  Google Scholar 

  5. Matthews GJ, Matthews ED, Goldstein M (1998) Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia. Fertil Steril 70:71–75

    Article  PubMed  CAS  Google Scholar 

  6. Male Infertility Best Practice Policy Committee of the American Urological Association, Practice Committee of the American Society for Reproductive Medicine (2006) Report on optimal evaluation of the infertile male. Fertil Steril 86:S202–S209

    Google Scholar 

  7. Sokol RZ (2009) Endocrinology of male infertility: evaluation and treatment. Semin Reprod Med 27:149–158

    Article  PubMed  Google Scholar 

  8. Chillon M, Casals T, Mercier B et al (1995) Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens. N Engl J Med 332:1475–1480

    Article  PubMed  CAS  Google Scholar 

  9. Paduch DA, Bolyakov A, Cohen P et al (2009) Reproduction in men with Klinefelter syndrome: the past, the present, and the future. Semin Reprod Med 27:137–148

    Article  PubMed  Google Scholar 

  10. Stahl PJ, Masson P, Mielnik A et al (2010) A decade of experience emphasizes that testing for Y microdeletions is essential in American men with azoospermia and severe oligozoospermia. Fertil Steril 94:1753–1756

    Article  PubMed  CAS  Google Scholar 

  11. Jow WW, Steckel J, Schlegel PN et al (1993) Motile sperm in human testis biopsy specimens. J Androl 14:194–198

    PubMed  CAS  Google Scholar 

  12. Schlegel PN (2009) Nonobstructive azoospermia: a revolutionary surgical approach and results. Semin Reprod Med 27:165–170

    Article  PubMed  Google Scholar 

  13. Schlegel PN (1999) Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod 14:131–135

    Article  PubMed  CAS  Google Scholar 

  14. Lewin A, Reubinoff B, Porat-Katz A et al (1999) Testicular fine needle aspiration: the alternative method for sperm retrieval in non-obstructive azoospermia. Hum Reprod 14:1785–1790

    Article  PubMed  CAS  Google Scholar 

  15. Levine LA, Dimitriou RJ, Fakouri B (2003) Testicular and epididymal percutaneous sperm aspiration in men with either obstructive or nonobstructive azoospermia. Urology 62:328–332

    Article  PubMed  Google Scholar 

  16. Hauser R, Yogev L, Paz G et al (2006) Comparison of efficacy of two techniques for testicular sperm retrieval in nonobstructive azoospermia: multifocal testicular sperm extraction versus multifocal testicular sperm aspiration. J Androl 27:28–33

    Article  PubMed  Google Scholar 

  17. Friedler S, Raziel A, Strassburger D et al (1997) Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Reprod 12:1488–1493

    Article  PubMed  CAS  Google Scholar 

  18. Westlander G, Hamberger L, Hanson C et al (1999) Diagnostic epididymal and testicular sperm recovery and genetic aspects in azoospermic men. Hum Reprod 14:118–122

    Article  PubMed  CAS  Google Scholar 

  19. Khadra AA, Abdulhadi I, Ghunain S et al (2003) Efficiency of percutaneous testicular sperm aspiration as a mode of sperm collection for intracytoplasmic sperm injection in nonobstructive azoospermia. J Urol 169:603–605

    Article  PubMed  Google Scholar 

  20. Practice Committee of American Society for Reproductive Medicine in collaboration with Society for Male Reproduction and Urology (2008) The management of infertility due to obstructive azoospermia. Fertil Steril 90:S121–S124

    Google Scholar 

  21. Carpi A, Sabanegh E, Mechanick J (2009) Controversies in the management of nonobstructive azoospermia. Fertil Steril 91:963–970

    Article  PubMed  Google Scholar 

  22. Issa MM, Hsiao K, Bassel YS et al (2004) Spermatic cord anesthesia block for scrotal procedures in outpatient clinic setting. J Urol 172:2358–2361

    Article  PubMed  Google Scholar 

  23. Meniru GI, Gorgy A, Podsiadly BT et al (1997) Results of percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection in two major groups of patients with obstructive azoospermia. Hum Reprod 12:2443–2446

    Article  PubMed  CAS  Google Scholar 

  24. Shrivastav P, Nadkarni P, Wensvoort S et al (1994) Percutaneous epididymal sperm aspiration for obstructive azoospermia. Hum Reprod 9:2058–2061

    PubMed  CAS  Google Scholar 

  25. Glina S, Fragoso JB, Martins FG et al (2003) Percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia. Int Braz J Urol 29:141–145, discussion 145–6

    Article  PubMed  Google Scholar 

  26. Craft I, Tsirigotis M, Bennett V et al (1995) Percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection in the management of infertility due to obstructive azoospermia. Fertil Steril 63:1038–1042

    PubMed  CAS  Google Scholar 

  27. Lin YH, Huang LW, Seow KM et al (2004) Intentional cryopreservation of epididymal spermatozoa from percutaneous aspiration for dissociated intracytoplasmic sperm injection cycles. Acta Obstet Gynecol Scand 83:745–750

    Article  PubMed  Google Scholar 

  28. Rosenlund B, Westlander G, Wood M et al (1998) Sperm retrieval and fertilization in repeated percutaneous epididymal sperm aspiration. Hum Reprod 13:2805–2807

    Article  PubMed  CAS  Google Scholar 

  29. Fahmy I, Kamal A, Aboulghar M et al (2004) Percutaneous aspiration biopsy using an intravenous catheter for testicular sperm retrieval in patients with obstructive azoospermia. Reprod Biomed Online 9:102–105

    Article  PubMed  Google Scholar 

  30. Sheynkin YR, Ye Z, Menendez S et al (1998) Controlled comparison of percutaneous and microsurgical sperm retrieval in men with obstructive azoospermia. Hum Reprod 13:3086–3089

    Article  PubMed  CAS  Google Scholar 

  31. Semiao-Francisco L, Braga DP, Figueira Rde C et al (2010) Assisted reproductive technology outcomes in azoospermic men: 10 years of experience with surgical sperm retrieval. Aging Male 13:44–50

    Article  Google Scholar 

  32. Belker AM, Sherins RJ, Dennison-Lagos L et al (1998) Percutaneous testicular sperm aspiration: a convenient and effective office procedure to retrieve sperm for in vitro fertilization with intracytoplasmic sperm injection. J Urol 160:2058–2062

    Article  PubMed  CAS  Google Scholar 

  33. Tournaye H (1999) Surgical sperm recovery for intracytoplasmic sperm injection: Which method is to be preferred? Hum Reprod 14(Suppl 1):71–81

    Article  PubMed  Google Scholar 

  34. Ezeh UI, Moore HD, Cooke ID (1998) A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia. Hum Reprod 13:3075–3080

    Article  PubMed  CAS  Google Scholar 

  35. Hovatta O, Moilanen J, von Smitten K et al (1995) Testicular needle biopsy, open biopsy, epididymal aspiration and intracytoplasmic sperm injection in obstructive azoospermia. Hum Reprod 10:2595–2599

    PubMed  CAS  Google Scholar 

  36. Rajfer J, Binder S (1989) Use of biopty gun for transcutaneous testicular biopsies. J Urol 142:1021–1022

    PubMed  CAS  Google Scholar 

  37. Tuuri T, Moilanen J, Kaukoranta S et al (1999) Testicular biopty gun needle biopsy in collecting spermatozoa for intracytoplasmic injection, cryopreservation and histology. Hum Reprod 14:1274–1278

    Article  PubMed  CAS  Google Scholar 

  38. Janzen N, Goldstein M, Schlegel PN et al (2000) Use of electively cryopreserved microsurgically aspirated epididymal sperm with IVF and intracytoplasmic sperm injection for obstructive azoospermia. Fertil Steril 74:696–701

    Article  PubMed  CAS  Google Scholar 

  39. Schroeder-Printzen I, Zumbe J, Bispink L et al (2000) Microsurgical epididymal sperm aspiration: Aspirate analysis and straws available after cryopreservation in patients with non-reconstructable obstructive azoospermia. MESA/TESE group giessen. Hum Reprod 15:2531–2535

    Article  PubMed  CAS  Google Scholar 

  40. Matthews GJ, Goldstein M (1996) A simplified method of epididymal sperm aspiration. Urology 47:123–125

    Article  PubMed  CAS  Google Scholar 

  41. Donoso P, Tournaye H, Devroey P (2007) Which is the best sperm retrieval technique for non-obstructive azoospermia? A systematic review. Hum Reprod Update 13:539–549

    Article  PubMed  CAS  Google Scholar 

  42. Colpi GM, Piediferro G, Nerva F et al (2005) Sperm retrieval for intra-cytoplasmic sperm injection in non-obstructive azoospermia. Minerva Urol Nefrol 57:99–107

    PubMed  CAS  Google Scholar 

  43. Vernaeve V, Verheyen G, Goossens A et al (2006) How successful is repeat testicular sperm extraction in patients with azoospermia? Hum Reprod 21:1551–1554

    Article  PubMed  Google Scholar 

  44. Friedler S, Raziel A, Schachter M et al (2002) Outcome of first and repeated testicular sperm extraction and ICSI in patients with non-obstructive azoospermia. Hum Reprod 17:2356–2361

    Article  PubMed  CAS  Google Scholar 

  45. Seo JT, Ko WJ (2001) Predictive factors of successful testicular sperm recovery in non-obstructive azoospermia patients. Int J Androl 24:306–310

    Article  PubMed  CAS  Google Scholar 

  46. Su LM, Palermo GD, Goldstein M et al (1999) Testicular sperm extraction with intracytoplasmic sperm injection for nonobstructive azoospermia: testicular histology can predict success of sperm retrieval. J Urol 161:112–116

    Article  PubMed  CAS  Google Scholar 

  47. Gil-Salom M, Romero J, Minguez Y et al (1998) Testicular sperm extraction and intracytoplasmic sperm injection: a chance of fertility in nonobstructive azoospermia. J Urol 160:2063–2067

    Article  PubMed  CAS  Google Scholar 

  48. Dardashti K, Williams RH, Goldstein M (2000) Microsurgical testis biopsy: a novel technique for retrieval of testicular tissue. J Urol 163:1206–1207

    Article  PubMed  CAS  Google Scholar 

  49. Amer M, Haggar SE, Moustafa T et al (1999) Testicular sperm extraction: impact of testicular histology on outcome, number of biopsies to be performed and optimal time for repetition. Hum Reprod 14:3030–3034

    Article  PubMed  CAS  Google Scholar 

  50. Hauser R, Botchan A, Amit A et al (1998) Multiple testicular sampling in non-obstructive azoospermia – is it necessary? Hum Reprod 13:3081–3085

    Article  PubMed  CAS  Google Scholar 

  51. World Health Organization (2010) WHO laboratory manual for the examination and processing of human semen. World Health Organisation, Geneva, p 271

    Google Scholar 

  52. Ostad M, Liotta D, Ye Z et al (1998) Testicular sperm extraction for nonobstructive azoospermia: results of a multibiopsy approach with optimized tissue dispersion. Urology 52:692–696

    Article  PubMed  CAS  Google Scholar 

  53. Steele EK, McClure N, Lewis S (2000) A comparison of the morphology of testicular, epididymal, and ejaculated sperm from fertile men and men with obstructive azoospermia. Fertil Steril 73:1099–1103

    Article  PubMed  CAS  Google Scholar 

  54. Okada H, Dobashi M, Yamazaki T et al (2002) Conventional versus microdissection testicular sperm extraction for nonobstructive azoospermia. J Urol 168:1063–1067

    Article  PubMed  Google Scholar 

  55. Carpi A, Menchini Fabris FG, Palego P et al (2005) Fine-needle and large-needle percutaneous aspiration biopsy of testicles in men with nonobstructive azoospermia: safety and diagnostic performance. Fertil Steril 83:1029–1033

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, Columbia University Medical Cente, 161 Fort Washington Ave 11th floor, New York, NY, 10032, USA

    Peter J. Stahl

  2. Department of Urology, James Buchanan Brady Foundation, Weill Cornell Medical College, 525 E 68th St, Starr 900, New York, NY, 10065, USA

    Peter N. Schlegel & Marc Goldstein

Authors
  1. Peter J. Stahl
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  2. Peter N. Schlegel
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  3. Marc Goldstein
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Corresponding author

Correspondence to Marc Goldstein .

Editor information

Editors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York, USA

    Zev Rosenwaks

  2. Dept. Developmental & Regenerative Biology, Ichan School of Medicine at Mount Sinai, New York, New York, USA

    Paul M. Wassarman

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Stahl, P.J., Schlegel, P.N., Goldstein, M. (2014). Sperm Retrieval and Quality Evaluation. In: Rosenwaks, Z., Wassarman, P. (eds) Human Fertility. Methods in Molecular Biology, vol 1154. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0659-8_17

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  • DOI: https://doi.org/10.1007/978-1-4939-0659-8_17

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-0658-1

  • Online ISBN: 978-1-4939-0659-8

  • eBook Packages: Springer Protocols

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