(TESE) Dissection into the testis itself, in men with azoospermia due to maturation arrest, to recover (by 'teasing out') immature sperm cells from the (often small) fraction of testicular tubules there which still contain such cells. The sperm cells are used for in vitro fertilisation using intracytoplasmic sperm insertion (ICSI).

A complete absence of sperm (spermatozoa) in the semen. Detectable only by performing a sperm count, as semen looks the same whether it contains sperm or not. Due either to an obstruction (usually in the epididymis or vas deferens), and called obstructive azoospermia, or to failure of sperm to form or to mature in the testis (called maturation arrest). See also spermatogenesis and testicular sperm extraction (TESE).

Congenital (present from birth) absence of the two vasa deferentia, which conduct sperm from the testes to the ejaculate; hence a cause of obstructive azoospermia. Because the vas deferens is usually affected on both sides, the word "bilateral" is often inserted, as CBAVD. Infertility is inevitable, but can be overcome using in vitro fertilisation with testicular sperm extraction. The cause, however, is usually the presence among the man's genes of one of the serious alleles for the genetic disease cystic fibrosis (which, having recessive inheritance, results when there are two such alleles present); it can also come about when there are one or two of the less serious abnormal alleles for this condition. The more common of the abnormal alleles should therefore be screened for (using a specially set up polymerase chain reaction on white blood cells): should an abnormal allele be present (delta F508 is the most common seriously abnormal one), the woman should be screened too, to predict the chance of cystic fibrosis occurring in the offspring.

A serious genetic disease (with a recessive inheritance pattern) characterised by a major disturbance of the body's mucus secretions, and thus a cause of incapacitating disease of the lungs. Important in our context because the heterozygous (or carrier) state in men can manifest with azoospermia due to congenital absence of the vasa deferentia -- the infertility of which is nowadays able to be overcome with testicular sperm extraction and ICSI, thus risking inadvertent transmission.

(MESA) Using microsurgery to dissect the epididymis or rete testis (or sometimes the tubules of the testis itself -- see also testicular sperm extraction) to find motile sperm cells suitable to be aspirated, isolated and prepared for an in vitro fertilisation procedure, usually involving sperm microinjection, especially intracytoplasmic sperm insertion.

Azoospermia caused by low sperm production rates in the testis, including maturation arrest. Can often be overcome with testicular sperm extraction (TESE) followed by in vitro fertilisation utilising intracytoplasmic sperm insertion (ICSI).

(ROSI) Experimental form of testicular sperm extraction (TESE) followed by intracytoplasmic sperm insertion (ICSI) in which a round (very immature) spermatid is isolated for injection into the egg (or oocyte). Seems to be less successful than a similar procedure in which the nucleus is isolated from the spermatid and used instead. Not recommended clinically.

(ROSNI) Experimental form of testicular sperm extraction (TESE) followed by intracytoplasmic sperm insertion (ICSI) in which the nucleus of a round (very immature) spermatid is isolated for injection into the egg (or secondary oocyte). Intended to be used in treating non-obstructive azoospermia with severe maturation arrest, when more spermatozoa are not obtainable. Animal studies show higher pregnancy rates than with round spermatid injection (ROSI), but limited studies in humans still indicate very high rates of embryopathy. Not recommended clinically.

In women, when measured during menstruation, inversely related to the serum FSH (and probably provides no more information than the day 3 FSH level in predicting depletion of eggs); in men with azoospermia, levels predict the likelihood of being able to obtain sperm for ICSI at testicular sperm extraction.

A biopsy of the testis to work out the reason behind an absence of sperm cells (azoospermia). Also used for testicular sperm extraction (TESE).