Sperm extraction at orchiectomy for testis cancer

Objective: To evaluate the value of aspirating sperm from the vas and epididymis at orchiectomy in azoospermic patients.Design: Retrospective clinical study. Setting: Tertiary care academic hospital.Patient(s): Three patients with known azoospermia who presented with testicular masses suspected to be cancerous. Intervention(s): At orchiectomy, immediately after ligation of the spermatic cord, the contents of the epididymis and vas deferens were extracted into preserving media. Main Outcome Measure(s): Fertility rate. Result(s): Sperm retrieval was successful in all three patients. The mean total sperm count was 2.3 × 10⁶/mL with 20% motility. Intracytoplasmic injection of sperm harvested by using this method was successful in two couples, one of which delivered a healthy infant. Conclusion(s): Sperm can be aspirated from the vas deferens and epididymis at orchiectomy for preservation. In azoospermic patients, this procedure may salvage enough sperm for successful use in micromanipulation techniques. It may be worthwhile to perform sperm aspiration during orchiectomy for testis cancer in any patient with known or suspected infertility.