The most severe form of male infertility is non obstructive azoospermia (NOA), where spermatogenesis is impaired or absent. If testicular sperm can be retrieved, men with NOA can become biological fathers with IVF/ ICSI. In Sweden, testicular sperm aspiration (TESA) is the most common method used to retrieve sperm but is only successful in up to 34% of procedures. In 2013, our fertility center introduced MD-TESE, where an operating microscope is used to target the biopsies. We have performed more than 134 MD-TESE procedures, mainly in cases where TESA sperm recovery failed previously. Sperm sufficient for ICSI were recovered in 52 % and in these cases 75 % resulted in embryo transfer, resulting in a 34 % ongoing pregnancy rate/deliveries per transfer. Results are encouraging and hopefully more Swedish IVF centers will introduce this technique.
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