doctor consulting with seated male patient in waiting room

Nonobstructive azoospermia is a challenging diagnosis for individuals and couples hoping to start a family. By learning about the different treatment options available, these patients can begin their path to parenthood with the right knowledge. We spoke to reproductive urologist Dr. Paul Turek, founder of The Turek Clinic, to learn more about the technique he developed and understand how this method contributes to the success of his patients’ family building goals.

What is sperm mapping?

Sperm mapping is a minimally invasive, non-surgical medical procedure that identifies the presence and location of sperm in the testicles. This procedure uses the Fine Needle Aspiration (FNA) technique and is sometimes referred to as sperm FNA mapping. Regardless of what we call it, sperm mapping helps azoospermic individuals with sperm-related fertility issues create embryos by determining a) whether there are sperm in the testicle and b) where sperm are located in the testicle, to justify a more invasive sperm retrieval procedure and help to guide that procedure.

What is nonobstructive azoospermia?

Nonobstructive azoospermia is a condition where the semen doesn’t contain any sperm. Individuals with this condition have testicles that don’t produce enough sperm to make it out of the testicle, but they may in fact have “pockets” of sperm within the testicle that if found can be used with IVF-ICSI to achieve pregnancies.

Can individuals with nonobstructive azoospermia have viable sperm?

About 50-60% of those with nonobstructive azoospermia may have viable sperm “pockets” within the testis. Sperm mapping is the most advanced technique available to inform patients whether they have testicular sperm that can later enable semen extraction for IVF-ICSI

How does sperm mapping assist in locating viable sperm?

Sperm mapping utilizes the minimally invasive FNA technique to locate sperm within the testicles. This technique is similar to a GPS system, which determines the route before the expedition begins. Sperm mapping allows providers to identify the precise location of testicular sperm before proceeding with invasive surgical sperm retrieval procedures. The doctor uses the information from sperm mapping to actually create a geographical “map” of each testicle. By directing the surgeon to the precise location of found sperm in the testicle, this allows for faster, less invasive TESE procedures with very high chances of finding sperm for IVF-ICSI (95-100%).

Should I ask my doctor if sperm mapping is right for me?

Sperm mapping is useful for individuals with no ejaculated sperm or azoospermia. If you’re struggling to conceive due to male-factor infertility, it is important to make an appointment with a reproductive urologist and discuss this procedure with your specialist. 

Are there other sperm mapping facts that are useful to know?

  1. Sperm Mapping in advance of sperm retrieval allows for simpler and usually (80%) one-sided sperm retrievals and can avoid more complex procedures (MicroTESE).
  2. Sperm “maps” that show no sperm can safely avoid unnecessary attempts at surgical sperm retrieval (1% false negative rate).
  3. Having sperm “maps” in advance allows TESE procedures to successfully find enough sperm to fertilize all eggs in 92 – 100% of IVF cases.
  4. Sperm mapping successfully locates sperm in up to 30% of individuals who have previously undergone microTESE sperm retrieval procedures that fail to find sperm.

References

  1. Beliveau, Monika E., and Paul J. Turek. “The Value of Testicular ‘Mapping’ in Men with Non-Obstructive Azoospermia.” Asian Journal of Andrology, vol. 13, no. 2, Medknow, Jan. 2011, pp. 225–30.
  2. Godart, Erica S., and Paul J. Turek. “The Evolution of Testicular Sperm Extraction and Preservation Techniques.” Faculty Reviews, vol. 9, Oct. 2020
  3. Jarvis. “Sperm Fine-needle Aspiration (FNA) Mapping After Failed Microdissection Testicular Sperm Extraction (TESE): Location and Patterns of Found Sperm.” Asian Journal of Andrology, vol. 21, no. 1, Medknow, Jan. 2019, p. 50.

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