Surgically retrieved sperm versus ejaculated sperm: What are the risks?

For men who have azoospermia or no sperm in the ejaculate, one solution to enable pregnancy is a surgical sperm retrieval.  In essence it is a minor surgical procedure whereby tissue or fluid with sperm is surgically removed from the testis or epididymis and that sperm is used to initiate a pregnancy through In Vitro Fertilization with ICSI.   Many couples take advantage of this procedure to have children; however, one concern that is often raised is whether there is any additional risk to the child when using surgically retrieved sperm.

An article from Oslo University hospital, Sweden and from University Hospital of Northern Norway, by  Tanbo et al  (Reprod Biomed Online, 2014) reports on more than four hundred pregnancies conceived over six years using non ejaculated sperm and compares results to more than nine hundred pregnancies conceived with ejaculated sperm.   Findings revealed that sex ratio, birth weight, rate of pregnancy loss, and incidence of congenital malformations showed no significant differences between the two groups.   These results should prove extremely reassuring to patients dealing with findings of azoospermia.    Given that I perform a number of surgical sperm retrieval procedures for my patient, this information will be genuinely helpful in my practice.