Surgical Sperm Retrieval(PESA / MESA / TESA / TESE)
Patients having Azoospermia (not able to produce sperms) can also have a chance at becoming fathers with their own genetic material with the help of surgical sperm retrieval techniques. Sperms obtained are then injected into the eggs of patient through micromanipulator to achieve pregnancy.
A variety of techniques exist for sperm retrieval for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), including percutaneous epididymal sperm aspiration, microsurgical epididymal sperm aspiration, testicular sperm aspiration, and open testicular sperm extraction. Each procedure is associated with its own risks and benefits, but all provide similar outcomes with appropriate patient selection.
Percutaneous Epididymal Sperm Aspiration (PESA)
PESA is indicated for men with irreparable obstruction resulting in Azoospermia (lack of or no sperm), congenital absence of the deferens or who have had vasectomies or failed vasectomy reversals. The procedure does not require a surgical incision. A small needle is passed directly into the head of the epididymis and fluid is aspirated. Next, the IVF laboratory team retrieves the cells from the fluid and prepares them for ICSI because of the amount secured.
Microsurgical Epididymal Sperm Aspiration (MESA)
Microsurgical epididymal sperm aspiration is performed in a similar manner to percutaneous epididymal sperm aspiration, except that it uses an open incision and a surgical microscope to aid in the harvesting of sperm. Both procedures may provide enough sperm for IVF-ICSI or cryopreservation, but the microsurgical approach is more precise as the epididymis is directly visualized under magnification.
Testicular Sperm Aspiration (TESA)
The procedure does not require a surgical incision. A small needle is passed directly into the testis and fluid is aspirated. Next, the IVF laboratory team retrieves the cells from the fluid and prepares them for ICSI because of the amount secured.
Testicular Tissue Sperm Extraction (TESE)
A testicular biopsy (or testicular sperm extraction) is executed through an open scrotal incision. It can be performed with or without the use of a surgical microscope. The testicle is exposed and a small transverse incision is made in the anterior aspect of the tunica albuginea. Standard open testicular sperm extraction techniques may not find spermatozoa in over half of men.