Erkek İnfertilitesinde İnvaziv Yönetim: Varikosel ve Azoospermide Cerrahi Yaklaşımlar

Agarwal A, Deepinder F, Cocuzza M, et all. Efficacy of varicocelectomy in improving semen parameters: new meta-analytical approach. Urology. 2007;70(3):532–538.

Male Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril. 2004;82(Suppl 1):S142–S145.

European Association of Urology. EAU Guidelines on Sexual and Reproductive Health 2025. Arnhem, The Netherlands: European Association of Urology; 2025.

Esteves SC, Miyaoka R, Roque M, et all. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J Androl. 2016;18(2):246–253.

Kim HJ, Lee YS, Seo JT. Clinical significance of subclinical varicocelectomy in male infertility: systematic review and meta-analysis. Andrologia. 2016;48(6):654–661.

Ding H, Tian J, Du W, Zhang L, Wang H, Wang Z. Open nonmicrosurgical, laparoscopic or open microsurgical varicocelectomy for male infertility: a meta-analysis of randomized controlled trials. BJU Int. 2012;110(10):1536–1542.

World Health Organisation. WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. 2000, Cambridge University Press: Cambridge.

Practice Committee of the American Society for Reproductive, M., et al. Report on varicocele and infertility: a committee opinion. Fertil Steril, 2014. 102: 1556.

Freeman S, Bertolotto M, Richenberg J, Belfield J, Dogra VS, Huang DY, et al. Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol. 2020;30(1):11–25.

Bertolotto M, Freeman S, Richenberg J, Belfield J, Dogra VS, Huang DY, et al. Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations. J Ultrasound. 2020;23(4):487–499.

Baazeem A, Belzile E, Ciampi A, Dohle G, Jarvi K, Salonia A, et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol. 2011;60(4):796–808. doi:10.1016/j.eururo.2011.06.018.

Damsgaard J, Joensen UN, Carlsen E, Erenpreiss J, Jensen MB, Matulevicius V, et al. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 healthy young men from six European countries. Eur Urol. 2016;70(6):1019–1029. doi:10.1016/j.eururo.2016.06.044.

Jensen CFS, Ostergren P, Dupree JM, Ohl DA, Sønksen J, Fode M. Varicocele and male infertility. Nat Rev Urol. 2017;14(9):523–533. doi:10.1038/nrurol.2017.98.

Kim KH, Lee JY, Kim SW, Paick JS. Impact of surgical varicocele repair on pregnancy rate in subfertile men with clinical varicocele and impaired semen quality: a meta-analysis of randomized clinical trials. Korean J Urol. 2013;54(10):703–709. doi:10.4111/kju.2013.54.10.703.

Asafu-Adjei D, Judge C, Dorsey P, Ramasamy R. Systematic review of the impact of varicocele grade on response to surgical management. J Urol. 2020;203(1):48–56. doi:10.1097/JU.0000000000000410.

Yamamoto M, Hibi H, Hirata Y, Miyake K, Ishigaki T. Effect of varicocelectomy on sperm parameters and pregnancy rate in patients with subclinical varicocele: a randomized prospective controlled study. J Urol. 1996;155(5):1636–1638. doi:10.1016/S0022-5347(01)66081-7.

Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, et al. Impact of varicocele repair on semen parameters in infertile men: a systematic review and meta-analysis. World J Mens Health. 2023;41(2):289–306. doi:10.5534/wjmh.220067.

Kroese AC, de Lange NM, Collins J, Evers JL. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev. 2012;10:CD000479. doi:10.1002/14651858.CD000479.pub5.

Persad E, Kroese AC, Collins J, Evers JL. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021;4(4):CD000479. doi:10.1002/14651858.CD000479.pub6.

Pazir, Y., Erdem, S., Cilesiz, N. C., & Kadioglu, A. (2021). Determination of the time for improvement in semen parameters after varicocelectomy. Andrologia, 53(1), e13895.

Peng J, Zhang Z, Cui W, et al. Spontaneous pregnancy rates in Chinese men undergoing microsurgical subinguinal varicocelectomy and possible preoperative factors affecting the outcomes. Fertil Steril. 2015;103(3):635-639. doi:10.1016/j.fertnstert.2014.12.091

Chen X, Yang D, Lin G, Bao J, Wang J, Tan W. Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis. Andrologia. 2017;49(10):10.1111/and.12778. doi:10.1111/and.12778

Lira Neto FT, Roque M, Esteves SC. Effect of varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis. Fertil Steril. 2021;116(3):696-712. doi:10.1016/j.fertnstert.2021.04.003

Kirby EW, Wiener LE, Rajanahally S, Crowell K, Coward RM. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016;106(6):1338-1343. doi:10.1016/j.fertnstert.2016.07.1093

Fabiani, A., et al. Do sclero-embolization procedures have advantages over surgical ligature in treating varicocele in children, adolescents and adults? Results from a systematic review and metaanalysis. Andrologia, 2022. 54: e14510.

McCullough, A., et al. A retrospective review of single-institution outcomes with robotic-assisted microsurgical varicocelectomy. Asian J Androl, 2018. 20: 189.

Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Male, R., et al. The management of obstructive azoospermia: a committee opinion. Fertil Steril, 2019. 111: 873.

Adamopoulos, D.A., et al. 'Value of FSH and inhibin-B measurements in the diagnosis of azoospermia'--a clinician's overview. Int J Androl, 2010. 33: e109.

Kalsi J, Thum MY, Muneer A, Abdullah H, Minhas S. In the era of micro-dissection sperm retrieval (m-TESE) is an isolated testicular biopsy necessary in the management of men with non-obstructive azoospermia?. BJU Int. 2012;109(3):418-424. doi:10.1111/j.1464-410X.2011.10399.x

Esteves SC, Miyaoka R, Agarwal A. Sperm retrieval techniques for assisted reproduction. Int Braz J Urol. 2011;37(5):570-583. doi:10.1590/s1677-55382011000500002

Van Peperstraten A, Proctor ML, Johnson NP, Philipson G. Techniques for surgical retrieval of sperm prior to ICSI for azoospermia. Cochrane Database Syst Rev. 2006;(3):CD002807. Published 2006 Jul 19. doi:10.1002/14651858.CD002807.pub2

Farber, N.J., et al. The Kinetics of Sperm Return and Late Failure Following Vasovasostomy or Vasoepididymostomy: A Systematic Review. J Urol, 2019. 201: 241.

Wan B, Wu Y, Wu Z, Zhou Z, Lu W. Current progress on the curative effects of vasoepididymostomy for patients with obstructive azoospermia: An updated systematic review and meta-analysis of human studies. Andrology. 2023;11(1):103-111. doi:10.1111/andr.13300

Etafy M, Gudeloglu A, Brahmbhatt JV, Parekattil SJ. Review of the role of robotic surgery in male infertility. Arab J Urol. 2017;16(1):148-156. Published 2017 Dec 13. doi:10.1016/j.aju.2017.11.006

Matthews GJ, Schlegel PN, Goldstein M. Patency following microsurgical vasoepididymostomy and vasovasostomy: temporal considerations. J Urol. 1995;154(6):2070-2073.

Ruiz-Romero J, Sarquella J, Pomerol JM. A new device for microsurgical sperm aspiration. Andrologia. 1994;26(2):119-120. doi:10.1111/j.1439-0272.1994.tb00769.x

Avellino GJ, Lipshultz LI, Sigman M, Hwang K. Transurethral resection of the ejaculatory ducts: etiology of obstruction and surgical treatment options. Fertil Steril. 2019;111(3):427-443. doi:10.1016/j.fertnstert.2019.01.001

Jiang HT, Yuan Q, Liu Y, et al. Multiple advanced surgical techniques to treat acquired seminal duct obstruction. Asian J Androl. 2014;16(6):912-916. doi:10.4103/1008-682X.139256

Choy JT, Eisenberg ML. Male infertility as a window to health. Fertil Steril. 2018;110(5):810-814. doi:10.1016/j.fertnstert.2018.08.015

Ventimiglia E, Ippolito S, Capogrosso P, et al. Primary, secondary and compensated hypogonadism: a novel risk stratification for infertile men. Andrology. 2017;5(3):505-510. doi:10.1111/andr.12335

Jensen CFS, Fode M, Østergren PB, Sønksen J. A Refined View on the Association Between Y-chromosome Microdeletions and Sperm Concentration. Eur Urol. 2019;76(5):637-638. doi:10.1016/j.eururo.2019.08.015

Bernie AM, Mata DA, Ramasamy R, Schlegel PN. Comparison of microdissection testicular sperm extraction, conventional testicular sperm extraction, and testicular sperm aspiration for nonobstructive azoospermia: a systematic review and meta-analysis. Fertil Steril. 2015;104(5):1099-103.e1033. doi:10.1016/j.fertnstert.2015.07.1136

Abur U, Gunes S, Ascı R, et al. Chromosomal and Y-chromosome microdeletion analysis in 1,300 infertile males and the fertility outcome of patients with AZFc microdeletions. Andrologia. 2019;51(11):e13402. doi:10.1111/and.13402

Jensen CF, Ohl DA, Hiner MR, et al. Multiple needle-pass percutaneous testicular sperm aspiration as first-line treatment in azoospermic men. Andrology. 2016;4(2):257-262. doi:10.1111/andr.12143

Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: follow-up by serial ultrasound examinations. Hum Reprod. 2000;15(3):653-656. doi:10.1093/humrep/15.3.653

Deruyver Y, Vanderschueren D, Van der Aa F. Outcome of microdissection TESE compared with conventional TESE in non-obstructive azoospermia: a systematic review. Andrology. 2014;2(1):20-24. doi:10.1111/j.2047-2927.2013.00148.x

Billa E, Kanakis GA, Goulis DG. Endocrine Follow-Up of Men with Non-Obstructive Azoospermia Following Testicular Sperm Extraction. J Clin Med. 2021;10(15):3323. Published 2021 Jul 28. doi:10.3390/jcm10153323

Corona G, Minhas S, Giwercman A, et al. Sperm recovery and ICSI outcomes in men with non-obstructive azoospermia: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(6):733-757. doi:10.1093/humupd/dmz028

Kalsi JS, Shah P, Thum Y, Muneer A, Ralph DJ, Minhas S. Salvage micro-dissection testicular sperm extraction; outcome in men with non-obstructive azoospermia with previous failed sperm retrievals. BJU Int. 2015;116(3):460-465. doi:10.1111/bju.12932

Caroppo E, Castiglioni F, Campagna C, et al. Intrasurgical parameters associated with successful sperm retrieval in patients with non-obstructive azoospermia undergoing salvage microdissection testicular sperm extraction. Andrology. 2021;9(6):1864-1871. doi:10.1111/andr.13082

Özman O, Tosun S, Bayazıt N, Cengiz S, Bakırcıoğlu ME. Efficacy of the second micro-testicular sperm extraction after failed first micro-testicular sperm extraction in men with nonobstructive azoospermia. Fertil Steril. 2021;115(4):915-921. doi:10.1016/j.fertnstert.2020.10.005

Eliveld J, van Wely M, Meißner A, Repping S, van der Veen F, van Pelt AMM. The risk of TESE-induced hypogonadism: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(4):442-454. doi:10.1093/humupd/dmy015

Oka S, Shiraishi K, Matsuyama H. Effects of human chorionic gonadotropin on testicular interstitial tissues in men with non-obstructive azoospermia. Andrology. 2017;5(2):232-239. doi:10.1111/andr.12292

Tharakan T, Corona G, Foran D, et al. Does hormonal therapy improve sperm retrieval rates in men with non-obstructive azoospermia: a systematic review and meta-analysis. Hum Reprod Update. 2022;28(5):609-628. doi:10.1093/humupd/dmac016

Shiraishi K, Ohmi C, Shimabukuro T, Matsuyama H. Human chorionic gonadotrophin treatment prior to microdissection testicular sperm extraction in non-obstructive azoospermia. Hum Reprod. 2012;27(2):331-339. doi:10.1093/humrep/der404

Agarwal A, Deepinder F, Cocuzza M, et all. Efficacy of varicocelectomy in improving semen parameters: new meta-analytical approach. Urology. 2007;70(3):532–538.

Male Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril. 2004;82(Suppl 1):S142–S145.

European Association of Urology. EAU Guidelines on Sexual and Reproductive Health 2025. Arnhem, The Netherlands: European Association of Urology; 2025.

Esteves SC, Miyaoka R, Roque M, et all. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J Androl. 2016;18(2):246–253.

Kim HJ, Lee YS, Seo JT. Clinical significance of subclinical varicocelectomy in male infertility: systematic review and meta-analysis. Andrologia. 2016;48(6):654–661.

Ding H, Tian J, Du W, Zhang L, Wang H, Wang Z. Open nonmicrosurgical, laparoscopic or open microsurgical varicocelectomy for male infertility: a meta-analysis of randomized controlled trials. BJU Int. 2012;110(10):1536–1542.

World Health Organisation. WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. 2000, Cambridge University Press: Cambridge.

Practice Committee of the American Society for Reproductive, M., et al. Report on varicocele and infertility: a committee opinion. Fertil Steril, 2014. 102: 1556.

Freeman S, Bertolotto M, Richenberg J, Belfield J, Dogra VS, Huang DY, et al. Ultrasound evaluation of varicoceles: guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection, classification, and grading. Eur Radiol. 2020;30(1):11–25.

Bertolotto M, Freeman S, Richenberg J, Belfield J, Dogra VS, Huang DY, et al. Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations. J Ultrasound. 2020;23(4):487–499.

Baazeem A, Belzile E, Ciampi A, Dohle G, Jarvi K, Salonia A, et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol. 2011;60(4):796–808. doi:10.1016/j.eururo.2011.06.018.

Damsgaard J, Joensen UN, Carlsen E, Erenpreiss J, Jensen MB, Matulevicius V, et al. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 healthy young men from six European countries. Eur Urol. 2016;70(6):1019–1029. doi:10.1016/j.eururo.2016.06.044.

Jensen CFS, Ostergren P, Dupree JM, Ohl DA, Sønksen J, Fode M. Varicocele and male infertility. Nat Rev Urol. 2017;14(9):523–533. doi:10.1038/nrurol.2017.98.

Kim KH, Lee JY, Kim SW, Paick JS. Impact of surgical varicocele repair on pregnancy rate in subfertile men with clinical varicocele and impaired semen quality: a meta-analysis of randomized clinical trials. Korean J Urol. 2013;54(10):703–709. doi:10.4111/kju.2013.54.10.703.

Asafu-Adjei D, Judge C, Dorsey P, Ramasamy R. Systematic review of the impact of varicocele grade on response to surgical management. J Urol. 2020;203(1):48–56. doi:10.1097/JU.0000000000000410.

Yamamoto M, Hibi H, Hirata Y, Miyake K, Ishigaki T. Effect of varicocelectomy on sperm parameters and pregnancy rate in patients with subclinical varicocele: a randomized prospective controlled study. J Urol. 1996;155(5):1636–1638. doi:10.1016/S0022-5347(01)66081-7.

Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, et al. Impact of varicocele repair on semen parameters in infertile men: a systematic review and meta-analysis. World J Mens Health. 2023;41(2):289–306. doi:10.5534/wjmh.220067.

Kroese AC, de Lange NM, Collins J, Evers JL. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev. 2012;10:CD000479. doi:10.1002/14651858.CD000479.pub5.

Persad E, Kroese AC, Collins J, Evers JL. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021;4(4):CD000479. doi:10.1002/14651858.CD000479.pub6.

Pazir, Y., Erdem, S., Cilesiz, N. C., & Kadioglu, A. (2021). Determination of the time for improvement in semen parameters after varicocelectomy. Andrologia, 53(1), e13895.

Peng J, Zhang Z, Cui W, et al. Spontaneous pregnancy rates in Chinese men undergoing microsurgical subinguinal varicocelectomy and possible preoperative factors affecting the outcomes. Fertil Steril. 2015;103(3):635-639. doi:10.1016/j.fertnstert.2014.12.091

Chen X, Yang D, Lin G, Bao J, Wang J, Tan W. Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis. Andrologia. 2017;49(10):10.1111/and.12778. doi:10.1111/and.12778

Lira Neto FT, Roque M, Esteves SC. Effect of varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis. Fertil Steril. 2021;116(3):696-712. doi:10.1016/j.fertnstert.2021.04.003

Kirby EW, Wiener LE, Rajanahally S, Crowell K, Coward RM. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016;106(6):1338-1343. doi:10.1016/j.fertnstert.2016.07.1093

Fabiani, A., et al. Do sclero-embolization procedures have advantages over surgical ligature in treating varicocele in children, adolescents and adults? Results from a systematic review and metaanalysis. Andrologia, 2022. 54: e14510.

McCullough, A., et al. A retrospective review of single-institution outcomes with robotic-assisted microsurgical varicocelectomy. Asian J Androl, 2018. 20: 189.

Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Male, R., et al. The management of obstructive azoospermia: a committee opinion. Fertil Steril, 2019. 111: 873.

Adamopoulos, D.A., et al. 'Value of FSH and inhibin-B measurements in the diagnosis of azoospermia'--a clinician's overview. Int J Androl, 2010. 33: e109.

Kalsi J, Thum MY, Muneer A, Abdullah H, Minhas S. In the era of micro-dissection sperm retrieval (m-TESE) is an isolated testicular biopsy necessary in the management of men with non-obstructive azoospermia?. BJU Int. 2012;109(3):418-424. doi:10.1111/j.1464-410X.2011.10399.x

Esteves SC, Miyaoka R, Agarwal A. Sperm retrieval techniques for assisted reproduction. Int Braz J Urol. 2011;37(5):570-583. doi:10.1590/s1677-55382011000500002

Van Peperstraten A, Proctor ML, Johnson NP, Philipson G. Techniques for surgical retrieval of sperm prior to ICSI for azoospermia. Cochrane Database Syst Rev. 2006;(3):CD002807. Published 2006 Jul 19. doi:10.1002/14651858.CD002807.pub2

Farber, N.J., et al. The Kinetics of Sperm Return and Late Failure Following Vasovasostomy or Vasoepididymostomy: A Systematic Review. J Urol, 2019. 201: 241.

Wan B, Wu Y, Wu Z, Zhou Z, Lu W. Current progress on the curative effects of vasoepididymostomy for patients with obstructive azoospermia: An updated systematic review and meta-analysis of human studies. Andrology. 2023;11(1):103-111. doi:10.1111/andr.13300

Etafy M, Gudeloglu A, Brahmbhatt JV, Parekattil SJ. Review of the role of robotic surgery in male infertility. Arab J Urol. 2017;16(1):148-156. Published 2017 Dec 13. doi:10.1016/j.aju.2017.11.006

Matthews GJ, Schlegel PN, Goldstein M. Patency following microsurgical vasoepididymostomy and vasovasostomy: temporal considerations. J Urol. 1995;154(6):2070-2073.

Ruiz-Romero J, Sarquella J, Pomerol JM. A new device for microsurgical sperm aspiration. Andrologia. 1994;26(2):119-120. doi:10.1111/j.1439-0272.1994.tb00769.x

Avellino GJ, Lipshultz LI, Sigman M, Hwang K. Transurethral resection of the ejaculatory ducts: etiology of obstruction and surgical treatment options. Fertil Steril. 2019;111(3):427-443. doi:10.1016/j.fertnstert.2019.01.001

Jiang HT, Yuan Q, Liu Y, et al. Multiple advanced surgical techniques to treat acquired seminal duct obstruction. Asian J Androl. 2014;16(6):912-916. doi:10.4103/1008-682X.139256

Choy JT, Eisenberg ML. Male infertility as a window to health. Fertil Steril. 2018;110(5):810-814. doi:10.1016/j.fertnstert.2018.08.015

Ventimiglia E, Ippolito S, Capogrosso P, et al. Primary, secondary and compensated hypogonadism: a novel risk stratification for infertile men. Andrology. 2017;5(3):505-510. doi:10.1111/andr.12335

Jensen CFS, Fode M, Østergren PB, Sønksen J. A Refined View on the Association Between Y-chromosome Microdeletions and Sperm Concentration. Eur Urol. 2019;76(5):637-638. doi:10.1016/j.eururo.2019.08.015

Bernie AM, Mata DA, Ramasamy R, Schlegel PN. Comparison of microdissection testicular sperm extraction, conventional testicular sperm extraction, and testicular sperm aspiration for nonobstructive azoospermia: a systematic review and meta-analysis. Fertil Steril. 2015;104(5):1099-103.e1033. doi:10.1016/j.fertnstert.2015.07.1136

Abur U, Gunes S, Ascı R, et al. Chromosomal and Y-chromosome microdeletion analysis in 1,300 infertile males and the fertility outcome of patients with AZFc microdeletions. Andrologia. 2019;51(11):e13402. doi:10.1111/and.13402

Jensen CF, Ohl DA, Hiner MR, et al. Multiple needle-pass percutaneous testicular sperm aspiration as first-line treatment in azoospermic men. Andrology. 2016;4(2):257-262. doi:10.1111/andr.12143

Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: follow-up by serial ultrasound examinations. Hum Reprod. 2000;15(3):653-656. doi:10.1093/humrep/15.3.653

Deruyver Y, Vanderschueren D, Van der Aa F. Outcome of microdissection TESE compared with conventional TESE in non-obstructive azoospermia: a systematic review. Andrology. 2014;2(1):20-24. doi:10.1111/j.2047-2927.2013.00148.x

Billa E, Kanakis GA, Goulis DG. Endocrine Follow-Up of Men with Non-Obstructive Azoospermia Following Testicular Sperm Extraction. J Clin Med. 2021;10(15):3323. Published 2021 Jul 28. doi:10.3390/jcm10153323

Corona G, Minhas S, Giwercman A, et al. Sperm recovery and ICSI outcomes in men with non-obstructive azoospermia: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(6):733-757. doi:10.1093/humupd/dmz028

Kalsi JS, Shah P, Thum Y, Muneer A, Ralph DJ, Minhas S. Salvage micro-dissection testicular sperm extraction; outcome in men with non-obstructive azoospermia with previous failed sperm retrievals. BJU Int. 2015;116(3):460-465. doi:10.1111/bju.12932

Caroppo E, Castiglioni F, Campagna C, et al. Intrasurgical parameters associated with successful sperm retrieval in patients with non-obstructive azoospermia undergoing salvage microdissection testicular sperm extraction. Andrology. 2021;9(6):1864-1871. doi:10.1111/andr.13082

Özman O, Tosun S, Bayazıt N, Cengiz S, Bakırcıoğlu ME. Efficacy of the second micro-testicular sperm extraction after failed first micro-testicular sperm extraction in men with nonobstructive azoospermia. Fertil Steril. 2021;115(4):915-921. doi:10.1016/j.fertnstert.2020.10.005

Eliveld J, van Wely M, Meißner A, Repping S, van der Veen F, van Pelt AMM. The risk of TESE-induced hypogonadism: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(4):442-454. doi:10.1093/humupd/dmy015

Oka S, Shiraishi K, Matsuyama H. Effects of human chorionic gonadotropin on testicular interstitial tissues in men with non-obstructive azoospermia. Andrology. 2017;5(2):232-239. doi:10.1111/andr.12292

Tharakan T, Corona G, Foran D, et al. Does hormonal therapy improve sperm retrieval rates in men with non-obstructive azoospermia: a systematic review and meta-analysis. Hum Reprod Update. 2022;28(5):609-628. doi:10.1093/humupd/dmac016

Shiraishi K, Ohmi C, Shimabukuro T, Matsuyama H. Human chorionic gonadotrophin treatment prior to microdissection testicular sperm extraction in non-obstructive azoospermia. Hum Reprod. 2012;27(2):331-339. doi:10.1093/humrep/der404