The emergence of specialized procedures for the acquisition, processing, and cryopreservation of epididymal and testicular sperm in connection with intracytoplasmic sperm injection.

Epididymal and testicular spermatozoa have been used widely for ICSI among men with obstructive azoospermia and NOA. New aspiration and biopsy techniques are available, and several sperm preparation methods have been described to isolate sperm. Most samples have sufficient sperm for cryopreservation. Accordingly, clinicians must sort through these new procedures to develop treatment plans that best suit their practices. In the future, other methods will be developed, and clinicians will have to critically review them prior to use.