To enhance testicular function and raise the possibility of sperm retrieval, azoospermic men with varicocele frequently undergo varicocele microligation. Fine-needle aspiration (FNA) mapping biopsy can be used to locate remaining foci of spermatogenesis in cases where initial microdissection testicular sperm extraction (mTESE) is unsuccessful. We report a 33-year-old man with persistent azoospermia 1 year after varicocele microligation and failed mTESE. Multiple locations containing sperm were found in both testes using FNA mapping; the majority of the sperm that were recovered were immotile sperm, which were later judged unsuitable for use in an in vitro fertilization/intracytoplasmic sperm injection program. This case illustrates that FNA mapping can reveal discrete areas of residual spermatogenesis even after repeated unsuccessful mTESE, although the functional quality of retrieved sperm may limit its clinical utility.
azoospermia ; fine-needle biopsies ; male infertility ; sperm retrieval