The role of microsurgery in the treatment of male infertility in Romania

M. C. Harza, S. N. Voinea, R. Vladareanu

Abstract: When facing an infertile male there are two main treatment options: either etiologic treatment or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Although FIV/ICSI is a remarkable procedure, we must resist the temptation of recommending it out of reflex to infertile couples due to male infertility, without a systematic urologic evaluation. Half of the males with infertility can be cured by a proper etiologic treatment. Microsurgical reconstruction in obstructive azoospermia and microsurgical subinguinal varicocelectomy are procedures with a better cost/efficiency ratio than FIV/ICSI and have the advantage of treating the cause of male infertility. In case of non-obstructive azoospermia, where the couple’s only chance of reproduction is FIV/ICSI, micro TESE is the most efficient method of retrieving sperm. Infertility specialists should offer their patients the chance to receive the best possible existing treatment, rather than the best possible treatment they can provide.
DOI:10.18643/gieu.2013.151

Keywords: male infertility, microsurgery, non-obstructive azoospermia, obstructive azoospermia, varicocele