title: Testicular sperm aspiration for nonazoospermic men: sperm retrieval and intracytoplasmic sperm injection outcomes.
abstract: OBJECTIVE
  To evaluate testicular sperm aspiration (TESA) sperm retrieval rates and intracytoplasmic sperm injection outcomes in nonazoospermic men.
  
  
  METHODS
  Data were collected retrospectively from 54 consecutive, nonazoospermic, infertile men who underwent TESA between March 2007 and September 2012. Sperm retrieval rates and clinical pregnancy outcomes were recorded. Patients were subgrouped based on clinical diagnosis: group 1, anejaculation (primary, situational); group 2, idiopathic severe oligoasthenozoospermia; and group 3, severe oligoasthenozoospermia after vasovasostomy.
  
  
  RESULTS
  Mean (± standard deviation) paternal and maternal ages were 39 ± 7 and 35 ± 5 years, respectively. Using TESA, sperm recovery was successful in 94% (51 of 54) of the men overall and in 100% (17 of 17) of the men in group 1, 90% (28 of 31) in group 2, and 100% (6 of 6) in group 3. Overall, 35% of the couples achieved a clinical pregnancy using TESA sperm (with a mean of 1.7 ± 0.9 embryos transferred per cycle). The clinical pregnancy rates were 40% in group 1, 33% in group 2, and 33% in group 3 with no significant difference in paternal or maternal age between groups.
  
  
  CONCLUSIONS
  The data indicate that TESA yields high sperm retrieval rates in select groups of nonazoospermic infertile men, and this approach results in acceptable pregnancy rates regardless of the male infertility etiology. Randomized controlled trials comparing ejaculated vs testicular sperm are needed to assess the true benefit of TESA-intracytoplasmic sperm injection in these couples.
authors.affiliation: Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alrabeeah
authors.affiliation: Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Faysal
authors.initials: F
authors.lastname: Yafi
authors.affiliation: OVO Fertility Clinic, Montreal, Quebec, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Flageole
authors.affiliation: OVO Fertility Clinic, Montreal, Quebec, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Phillips
authors.affiliation: OVO Fertility Clinic, Montreal, Quebec, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Wachter
authors.affiliation: OVO Fertility Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Francois
authors.initials: F
authors.lastname: Bissonnette
authors.affiliation: OVO Fertility Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Isaac Jacques
authors.initials: IJ
authors.lastname: Kadoch
authors.affiliation: Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada; OVO Fertility Clinic, Montreal, Quebec, Canada. Electronic address: ziniarmand@yahoo.com.
authors.forename: Armand
authors.initials: A
authors.lastname: Zini
mesh_terms: D000328:Adult; D053713:Azoospermia; D015331:Cohort Studies; D004542:Ejaculation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D053625:Sperm Retrieval; D016896:Treatment Outcome