
This study determined the most financially optimal surgical approach for testicular sperm retrieval in men with non-obstructive azoospermia (NOA). A decision tree analysis was conducted, evaluating five surgical options for one cycle of ICSI. The expected net loss was calculated for each approach based on couples' willingness to pay (WTP) for one cycle resulting in pregnancy. The results showed that frozen microsurgical TESE (m-TESE) consistently presented the lowest net loss compared to other options, making it the most financially optimal decision for couples paying out of pocket for NOA management.
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