ABSTRACT
In the past 10-20 years, several changes have taken place in clinical andrology. Gradually, empirical treatments have been replaced by techniques of assisted reproduction-intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection. The introduction of intracytoplasmic sperm injection (ICSI), in particular, has completely changed the clinical approach towards male infertility. A single spermatozoon can be injected into an oocyte and result in normal fertilization, embryonic development, and implantation. Not only ejaculated spermatozoa can be used; epididymal or testicular spermatozoa also can be used for ICSI. Surgical retrieval of spermatozoa for ICSI has therefore become a routine technique in clinical andrology. Several techniques are available in order to retrieve epididymal or testicular spermatozoa. Although there is no real method of choice, some guidelines may be given in order to make the best choice for a specific clinical setting.
