Novel methods to enhance surgical sperm retrieval: a systematic review

Eliyahu Kresch, Iakov Efimenko, Daniel Gonzalez, Paul J. Rizk, Ranjith Ramasamy

Research output: Contribution to journalReview articlepeer-review


Objectives: To explore the use of novel technologies in sperm retrieval in men with azoospermia due to a production defect. Methods: We performed a Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA)-compliant systemic literature review for manuscripts focussed on novel sperm-retrieval methods. We identified 30 studies suitable for qualitative analysis. Results and Conclusions: We identified multiple new promising technologies, each with its own distinct set of benefits and limitations, to enhance chances of sperm retrieval; these include the use of multiphoton microscopy, Raman spectroscopy, and full-field optical coherence tomography during a microdissection-testicular sperm extraction procedure. ORBEYE and ultrasonography technologies can also serve to better visualise areas of sperm production. Finally, artificial intelligence technology can play a role in the identification of sperm and, perhaps, better-quality sperm for use with assisted reproduction. Abbreviations: AI: artificial intelligence; ANN: artificial neural network; ART: assisted reproductive technology; 3D: three-dimensional; DNN: deep neural networks; FFOCT: full-field optical coherence tomography; H&E: haematoxylin and eosin; ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilisation; MESA: micro-epididymal sperm aspiration; MeSH: Medical Subject Heading; MPM: multiphoton microscopy; (N)OA: (non-)obstructive azoospermia; SCO: Sertoli cell-only syndrome; SRR: sperm retrieval rates; TESA: testicular sperm aspiration; (micro-)TESE: (microdissection-) testicular sperm extraction; (CE)US: (contrast-enhanced) ultrasonography.

Original languageEnglish (US)
Pages (from-to)227-237
Number of pages11
JournalArab Journal of Urology
Issue number3
StatePublished - 2021


  • Azoospermia
  • artificial intelligence
  • infertility
  • micro-TESE
  • ultrasonography

ASJC Scopus subject areas

  • Urology


Dive into the research topics of 'Novel methods to enhance surgical sperm retrieval: a systematic review'. Together they form a unique fingerprint.

Cite this