The most challenging scenario facing an infertile man is non-obstructive azoospermia (NOA), having a sperm count of zero due to a sperm production failure rather than due to a blockage.
For most men with NOA there is an opportunity to undergo microdissection testicular sperm extraction (microTESE), a highly meticulous microsurgical search through the testicle for small pockets of sperm production to retrieve very small numbers of sperm that may be used with IVF to allow the couple an opportunity to conceive with the male partner’s sperm and the female partner’s eggs. Success rates vary based on surgeon and center. At AFRM, Dr. Parviz Kavoussi performs microTESEs for men with NOA frequently with high success rate. As a renowned leader in microTESE, he recently was charged with the task to co-author a large study evaluating international practice patterns on surgical treatment of men with NOA. Dr. Kavoussi states, “It was quite eye opening to see the variation of practice patterns globally. Here in the U.S., there are established guidelines but unfortunately, we can see variations even here, which can impact the odds of success, so ultimately some level of standardization is needed to optimize couples’ outcomes wherever they are seeking care.”
