Sperm retrieval techniques in azoospermic patients: PESA, MESA, TESA, TESE and MICROTESE Técnicas de recuperação de espermatozoides em pacientes azoospérmicos: PESA, MESA, TESA, TESE e MICROTESE

Received on: April 28, 2009 – Accepted on: Oct 15, 2009 aBstRact Azoospermia is defined as the absence of mature spermatozoa in semen analysis after centrifugation. The causes of azoospermia may be related to spermatogenesis defects and classified as nonobstructive azoospermia, or to the obstruction of the efferent ducts of the genital tract and classified as obstructive azoospermia. Before the development of intracytoplasmic sperm injection, in 1992, men with non-treatable obstructive azoospermia or non-obstructive azoospermia could not become biologic fathers. Intracytoplasmic sperm injection has dramatically changed this scenario, as it allows obtaining an embryo using a single sperm cell. Since then, sperm obtained from different sources have been used for intracytoplasmic sperm injection, and the techniques used for sperm retrieval are microsurgical epididymal sperm aspiration (MESA) or percutaneous epididymal sperm aspiration (PESA) for patients with obstructive azoospermia, and testicular sperm aspiration (TESA), testicular sperm extraction (TESE) or testicular microdissection for non-obstructive azoospermia patients. This article discusses these techniques, and their indications and results.