The inability to deposit sperm in the vagina during sexual intercourse has traditionally been one of the absolute causes of infertility.
Until the introduction of the most complex assisted reproduction techniques, the only option that could be contemplated was the use of a donor sperm sample.
With the development of in vitro fertilization (IVF) techniques, and especially with oocyte insemination by means of sperm microinjection (ICSI), the possibility of conceiving with a scarce number of spermatozoa is feasible.
In patients suffering from impotence that is not a consequence of andrological or psychological medical treatment, an epididymal aspiration or testicular biopsy may be performed.
Epididymal aspiration consists of extracting the sperm stored in the epididymis using local anesthesia, where they acquire the ability to move after being generated in the seminal ducts.
Biopsy is reserved in cases of epididymal aspiration with negative results and requires access to mature sperm directly from the testicular tissue. Although it can be performed under local anesthesia, it can also be performed under anesthetic sedation, which allows the procedure to be performed at different points or on both testicles.