Methods of Surgical Sperm Retrieval
Microepididymal Sperm Aspiration (MESA)
Outpatient microsurgical procedure used to collect sperm in men with blockage of the male reproductive ducts such as prior vasectomy or absence of the vas deferens (Obstructive Azoospermia). The spermatozoa found with MESA are used for an IVF treatment using the ICSI procedure.
Percutaneous testicular Sperm Aspiration (PESA)
PESA is a sperm aspiration procedure in which a needle is inserted into the epididymis (the gland that carries sperm from testicle to vas deferens) in order to retrieve sperm to be used in an IVF procedure. The procedure is performed either by local or general anaesthesia. If no spermatozoa are collected by this method then we reschedule this patient for operation by a different method (MESA, TESE).
Testicular Sperm Extraction (TESE)
TESE is the operative removal of testicular tissue in an attempt to collect living sperm to be used in an IVF procedure. It is normally performed in Obstructive Azoospermia patients and could be performed either by local or general anaesthesia by a surgeon/andrologist. The tissue is sent to our andrology laboratory and analysed under the microscope by the embryologist. Spermatozoa collected by this method are used for IVF using the ICSI procedure.
Testicular Sperm Aspiration (TESA)
It is the insertion of a needle into the lower region of the testes and the removal of a small piece of testicular tissue. Examination of the tissue is performed microscopically in the laboratory by the embryologist. Spermatozoa collected by this method are used for IVF using the ICSI procedure.
For patients that are referred for testicular biopsy due to non-obstructive azoospermia micro-TESE can be offered instead of a regular biopsy. In most cases spermatozoa are found in the seminiferous tubules collected. The procedure is performed by an experienced surgeon/andrologist and a skilful embryologist who will be searching for spermatozoa. During microTESE procedure the embryologist is analysing the seminiferous tubules with the use of a microscope installed in the operating theatre. The spermatozoa found with micro-TESE will be used for an IVF treatment using the ICSI procedure.
If supernumerary spermatozoa are found, we proceed with cryopreservation either by the classical sperm freezing or the SpermVD (sperm vitrification) method. The whole procedure is performed under anaesthesia. Normally the patient will be feeling much better with minimal pain after 24-48 hours but it is advised to avoid heavy works, sexual intercourse or masturbation for 8-10 days. The procedure could be repeated in subsequent cycles if needed.