One percent of men in the United States are azoospermic, or have no sperm in their semen and 10-15% of men who go to the doctor to be evaluated for infertility will have no sperm in their semen. Men with azoospermia are categorized as those with an anatomic blockage not allowing sperm to get to the female reproductive tract, known as obstructive azoospermia, or as those who lack sperm in the semen due to an inadequate production of sperm in the testicles, known as non-obstructive azoospermia. In cases of non-obstructive azoospermia, a specialized procedure termed microdissection testicular sperm extraction (microTESE) may be performed by a Reproductive Urologist with microsurgical expertise, to give these couples a chance to conceive with the man’s sperm and the woman’s egg using sperm retrieved directly from the testicle. This is a meticulous microsurgical technique used to look for possible pockets of sperm production throughout the testicle under 15-20 times magnification with an operative microscope to find sperm that can be used in combination with in vitro fertilization (IVF) to achieve a pregnancy. The success rates of retrieving sperm using this procedure are highly dependent on the training and experience of the microsurgeon, and the procedure should be performed by specialty fellowship trained experts. Dr. Kavoussi’s retrieval rates rival those anywhere.
Dr. Parviz Kavoussi has published a basic science study in the Journal of Urology examining the first step in a potential way to improve these outcomes (Smith,Lowe, Kavoussi, Steers, Costabile, Herr, Shetty, Lysiak. Confocal fluorescent microscopy in a murine model of microdissection testicular sperm extraction to improve sperm retrieval. Journal of Urology. 2012 May;187(5):1918-1923.) “This study evaluated at our ability to identify microscopic pockets of sperm production by fluorescently labeling the sperm cells in a mouse model mimicking the testicular architecture of men with no sperm in their semen. This is a first step in applying such technology to men in this situation. More studies will certainly be needed before being able to apply this to humans, but this is a landmark step in that direction! Although treating patients is the primary priority, it is very exciting to be able to contribute to the field scientifically in ways that can potential revolutionize the way we treat subfertile men.”