International consensus on perioperative management of testicular microtesticular sperm extraction (micro-TESE)
I. Background and clinical significance Non-obstructive azoospermia (NOA) is the most serious type of male infertility. Microtesticular sperm extraction (micro-TESE) has been widely used worldwide as the primary means of obtaining sperm in patients with NOA. Its perioperative management covers key aspects such as patient education, endocrine evaluation, microsurgical operation, enhanced recovery after surgery (ERAS), testicular sperm freezing and thawing technique, and long-term follow-up. Standardized perioperative management is essential to improve sperm retrieval rate (SRR) and assisted reproductive technology (ART) outcomes. History of technology development Origin: First proposed by Schlegel’s team in 1999, the technique identifies and extracts spermatozoa from focal seminiferous tubules by microscopic manipulation. Recommended by international guidelines: American Society for Reproductive Medicine (ASRM): micro-TESE is the procedure with the highest SRR…
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