Abstract
Introduction: Assisted conception is an option for subfertile couples. Surgical sperm retrieval by testicular sperm aspiration and testicular sperm extraction are widely used safe techniques to yield sperm for intracytoplasmic sperm injection. Experience with these techniques is presented.
 Materials and Methods: A retrospective study of testicular sperm retrieval for assisted reproduction is presented. Testicular sperm aspiration is attempted on all azoospermic males with normal sexual characteristics. Testicular sperm extraction is attempted on consenting patients where aspiration has failed. Donor sperm injection is done to oocyte of a spouse on the failure of both techniques.
 Results: Sixty-six percent of males had adequate numbers and characters of viable spermatozoa on testicular sperm aspiration. Further 53.3% of patients where aspiration failed yielded spermatozoa on testicular sperm extraction. Thus overall 77.1 % of patients with azoospermia benefi tted from testicular sperm retrieval techniques.
 Conclusions: Testicular sperm aspiration is a technically easy, quick, safe, and cheap method of sperm retrieval. Testicular sperm extraction is a safe adjunct to aspiration with better yield.
Highlights
Assisted conception is an option for subfertile couples
Overall 77.1 % of patients with azoospermia benefitted from testicular sperm retrieval techniques
Testicular sperm extraction is a safe adjunct to aspiration with better yield
Summary
Assisted conception is an option for subfertile couples. Surgical sperm retrieval by testicular sperm aspiration and testicular sperm extraction are widely used safe techniques to yield sperm for intracytoplasmic sperm injection. A man is considered sterile and cannot father his genetic offspring if no sperm are detected in different locations of the testes Under such circumstances, the use of donor sperm or adoption are the only available options remaining for the couple to have a child.[1] Subfertility affects one in 20 men.[2] Abnormal semen quality or sexual dysfunction are contributing factors in about half of subfertile couples.[2] A couple with subfertility of longer than three years, or with a non-reversible form of subfertility is unlikely to conceive spontaneously and should be advised for assisted conception.[2] Surgical sperm retrieval for intracytoplasmic sperm injection is indicated in obstructive azoospermia where spermatogenesis is usually normal, or non-obstructive azoospermia where spermatogenesis is present on biopsy.[2] Results of retrieved testicular spermatozoa for intracytoplasmic sperm injection using surgically retrieved sperm are similar to those where ejaculated sperm is used.[2,3] We present results of our experience with testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) techniques
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