Testicular Sperm Extraction in Male Factor Infertility
What is Testicular Sperm Extraction?
Testicular sperm extraction, or sperm retrieval, is an advanced microsurgical technique used to harvest sperm in cases of male factor infertility where there is little or no sperm present in the ejaculate.
Why Consider Testicular Sperm Extraction?
Sperm retrieval is a minimally invasive procedure that has proven effective at obtaining viable sperm for use in IVF (in vitro fertilization). The fertility urology specialists affiliated with MRM have extensive experience in extracting sperm. In fact, sperm retrieval after vasectomy and even after chemotherapy is now being performed on a routine basis.
Diagnosis for Male Factor Infertility
To know whether sperm retrieval is the right male factor infertility treatment for you, you need to start by getting an accurate diagnosis to uncover the specific cause of infertility.
Types of Sperm Extraction
Based on the male partner’s semen analysis and a thorough physical examination, MRM’s fertility specialists will determine the most appropriate method of testicular sperm extraction. Sperm are directly obtained either from the epididymis or the testicles. Retrieval from the epididymis is preferred wherever possible, because epididymal sperm responds better to cryopreservation (freezing).
The most commonly used types of sperm retrieval are:
- PESA or MESA (microsurgical epididymal sperm aspiration)
If there is sperm in the epididymis, either PESA (percutaneous epididymal sperm aspiration) or MESA (microsurgical epididymal sperm aspiration) is preferred as a sperm retrieval method. Under local anesthesia, PESA is the most minimally invasive procedure with a needle passing through the scrotal skin directly into the epididymus from which sperm is quickly drawn up. MESA is more involved and includes a small incision is made in the scrotum. A micropuncture pipette quickly and accurately punctures the epididymal tubule, and the sperm is aspirated through the pipette. The sperm is examined under a microscope for viability, and the incision is closed.
- TESE (testicular sperm extraction)
For men with little or no sperm in the epididymis, or if there is no epididymis, sperm can be retrieved directly from the testicles. Performed under either local anesthesia or IV conscious sedation (sleeping and breathing on your own), a sliver of testicular tissue is microdissected under an operating microscope. The procedure takes only a few minutes and causes very little post-operative pain or discomfort. Pregnancy success rates are similar to those achieved with epididymal sperm.
Any excess sperm from either epididymal extraction (MESA) or testicular extraction (TESE) can be cryopreserved (MRM’s fertility specialists are experts in sperm freezing) for use later, although sperm from these sources exhibit greater sensitivity to freezing than ejaculated sperm. Therefore, patients may sometimes require a second TESE or MESA procedure in case no sperm are viable upon thawing.
Using Retrieved Sperm in IVF
After the retrieved sperm are washed and further prepared in the IVF lab, they are injected directly into the partner’s eggs using intracytoplasmic sperm injection (ICSI), and the IVF cycle proceeds as usual. Many Michigan, northern Ohio and Canadian couples with male factor infertility have successfully conceived with IVF using sperm extraction methods. The refinement of microsurgical techniques, combined with advances in cryopreservation technology, has resulted in high pregnancy rates.
Minimally Invasive Surgery: Varicocele repair and Vasectomy Reversal
To know whether sperm minimally invasive surgery is the right male factor infertility treatment for you, you need to start by getting an accurate diagnosis to uncover the specific causes of infertility. Substantially enlarged varicose veins within the scrotum called varicoceles that may be reducing sperm quantity or quality. There may be improvement with removal of these varicose veins. After previous vasectomy, an alternative to epididymal sperm aspiration is vasectomy reversal. MRM’s fertility urologist specialists will determine whether these minimally invasive surgical options are of benefit to achieving your goal of having a child.
To Find Out if Sperm Retrieval May be an Option for You:
Call MRM at (248) 593-6990 to speak to one of our helpful, friendly fertility consultants. They will be happy to answer any questions you might have regarding sperm retrieval or anything else, and can quickly schedule a consultation for you with one of our fertility experts. If you prefer, simply click here to contact us.
