Sperm retrieval rates and ICSI outcomes for men with nonobstructive azoospermia and the health of resulting offspring

report on the results of a reasonably large (365) retrospective series of patients with nonobstructive azoospermia (NOA) who had sperm collected by microscopically assisted microdissection (microTESE) for intracytoplasmic sperm injection (ICSI). The results from NOA patients are compared with previously published data from a group of men with obstructive azoospermia collected during the same time frame. In addition, as is standard of care, the couples were offered ICSI with donor sperm if the microTESE procedure failed to yield sperm, providing a group from the same cohort who had ejaculated sperm used for ICSI. NOA describes the condition in which there are no sperm in the semen due to lack of sperm production by the testes, rather than due to posttesticular obstruction of the excurrent ducts. NOA accounts for about 7% of male factor infertility cases and includes patients with Y‑chromosome deletions, Klinefelter syndrome and prior cancer treatment. Until the advent of surgical collection of testicular sperm and ICSI, men with NOA were unable to father biological offspring. Now, using TESE, sperm can be collected for injection into oocytes. 2