Recent advances in reproductive medicine have allowed men who were previously considered sterile to become biological fathers to their children. If the male partner has fertility issues that are identified in the analysis or other tests then the ICSI procedure can also be combined with sperm retrieval procedures.
Non-obstructive azoospermia (or abnormal sperm production) is a very common cause of male infertility. Here at euroCARE IVF, expert fertility doctors — Dr. Armağan Ulubaş, recommend microsurgical testicular sperm extraction (microTESE) for non-obstructive azoospermia.
Sperm are retrieved from the testes through a small incision and are used for the fertilization of eggs in the laboratory. Careful coordination with the female partner’s reproductive endocrinologist is essential during the In Vitro Fertilization (IVF) process.
Why Consider Sperm Retrieval?
Sperm retrieval is an advanced micro-surgical technique used to harvest sperm in cases of male factor infertility when there is little or no sperm present in the ejaculate. It is a minimally invasive procedure that has proven effective at obtaining viable sperm for use for in vitro Fertilization (IVF).
Sperm production problems can result from hormonal problems, testicular failure, varicocele, or varicose veins in the testicles. We perform the following sperm retrieval procedures:
PESA (Percutaneous Sperm Aspiration). This is where sperm is collected directly from the epididymis (a reservoir of sperm that sits atop each testicle) using a syringe and fine needle.
TESA (Testicular Sperm Aspiration). This is where a fine needle is passed directly into the testes to retrieve a small number of the seminiferous tubules. Seminiferous tubules are located within the testes, and are the specific location of meiosis, and the subsequent creation of male gametes, namely spermatozoa.
TESE (Testicular Sperm Extraction). This is the process of removing a small portion of tissue from the testicle and extracting the few viable sperm cells present in that tissue.
Micro TESE. The procedure is performed on each testicle through a very small incision in the scrotum. The testicles are opened through the incision and examined by a high power microscope identifying the seminiferous tubules that are swollen and contain sperm. A sample is then taken. Patients are left with a suture that will dissolve leaving little or no scar.
The success rate of these surgical sperm retrieval methods is very similar to the success using sperm ejaculation. The sperm collected can then be examined and used as part of the IVF with ICSI process.
What is Microscopic TESE?
The procedure is performed through a very small (3–4 cm) incision in the scrotum. The patient is under general anesthesia before surgery. The testicles are opened through the incision and magnified under a high power, operating microscope (at 30–40X magnification) to locate seminiferous tubules that are swollen and contain sperm.
Once we have taken a sample of sperm from one side’s tubules or after we have sampled all the tissue, our doctors close the testis with a suture. We will repeat the identical procedure on the opposite side.
After collecting the samples, our expert euroCARE IVF fertility specialists will close all the layers of tissue that were opened to enter the scrotum. The sample tissue is sent to our andrology technologist who will examine it under a standard microscope to look for the presence of sperm.
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