Surgical Sperm Retrieval Techniques for Assisted Reproductive Technology

Year 2022, Volume: 24 Issue: Special Issue, 44 - 48, 30.10.2022

Mehmet Vehbi Kayra Tahsin Turunç

https://doi.org/10.18678/dtfd.1184182

Abstract

Intracytoplasmic sperm injection provides in vitro fertilization for many infertility conditions. It is also an important treatment option for fertilization in azoospermic men. Sperm production in azoospermic male testicles is possible. In these patients, sperm extraction from the epididymis or testis is required before intracytoplasmic sperm injection. Numerous sperm retrieval procedures for obtaining sperm from the epididymis or testicles have been developed. The spermatozoa obtained by these methods are used in intracytoplasmic sperm injection for in vitro fertilization. The most important factor when determining the sperm retrieval method is whether the azoospermia is obstructive or non-obstructive. In addition, the experience of the surgeon performing the procedure is also effective in determining the sperm retrieval technique. In this review, sperm retrieval methods are presented, and current developments in these sperm retrieval methods are also mentioned. The indications of surgical sperm retrieval methods in both obstructive and non-obstructive azoospermic patients, the technical aspects of each method, possible complications, advantages and disadvantages of these methods are presented, and their superiority to each other are also discussed. In addition, evidence for the fertilization rates after intracytoplasmic sperm injection using sperm obtained by these methods and continuation of pregnancy is presented in a comparative manner and critically discussed.

Keywords

Sperm retrieval, assisted reproductive techniques, male infertility, azoospermia

Yardımcı Üreme Teknolojisi için Cerrahi Sperm Elde Etme Teknikleri

Abstract

İntrasitoplazmik sperm enjeksiyonu, birçok infertilite koşulu için in vitro fertilizasyon sağlamaktadır. Azospermik erkeklerde de fertilizasyon için önemli bir tedavi seçeneğidir. Azospermik erkek testislerinde sperm üretimi mümkündür. Bu hastalarda intrasitoplazmik sperm enjeksiyonundan önce epididim veya testisten sperm alınması gerekir. Epididim veya testislerden sperm elde etmek için çok sayıda sperm alma prosedürü geliştirilmiştir. Bu yöntemlerle elde edilen spermler, in vitro fertilizasyon için intrasitoplazmik sperm enjeksiyonunda kullanılmaktadır. Sperm alma yöntemini belirlerken en önemli faktör azosperminin obstrüktif veya non-obstrüktif olup olmadığıdır. Ayrıca işlemi yapan cerrahın tecrübesi de sperm alma tekniğinin belirlenmesinde etkilidir. Bu derlemede sperm elde etme yöntemleri anlatılmış ve ayrıca bu sperm elde etme yöntemleri ile ilgili güncel gelişmeler de ele alınmıştır. Hem obstrüktif hem de non-obstrüktif azospermik hastalarda cerrahi sperm elde etme yöntemlerinin endikasyonları, her bir yöntemin teknik yönleri, olası komplikasyonları, bu yöntemlerin avantaj ve dezavantajları anlatılmış ve birbirlerine göre üstünlükleri de tartışılmıştır. Ayrıca, bu yöntemlerle elde edilmiş olan sperm kullanılan intrasitoplazmik sperm enjeksiyonu sonrası fertilizasyon oranları ve gebeliğin devamına ilişkin kanıtlar karşılaştırmalı bir şekilde sunulmuş ve eleştirel bir şekilde tartışılmıştır.

Keywords

Sperm toplama, yardımcı üreme teknikleri, erkek infertilitesi, azospermi

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