ABSTRACT
With the advent of intracytoplasmic injection (ICSI), men with nonobstructive azoospermia who were previously considered hopelessly infertile now can potentially initiate pregnancy, if mature spermatozoa can be harvested from the testes.1-5 Schoysman et al first demonstrated that spermatozoa extracted from the testis are able to successfully fertilize human oocytes, leading to pregnancy.6-8 Patients with a predominant pattern of germinal cell aplasia on previous testis biopsies have been found to have mature spermatozoa in 25% of the cases in which repeat biopsy is performed. Similarly, close to 50% of patients with spermatogenic maturation arrest are also found to have mature spermatozoa on testicular biopsy.9 The corollary, of course, is that mature sperm will not be found in 50-75% of patients with spermatogenic failure, despite meticulous dissection at the time of attempted testicular sperm extraction (TESE).
