Recent advances in reproductive medicine have allowed men who were previously considered sterile to become biological fathers to their children. A new surgical technique, called Microsurgical Testicular Sperm Extraction or Microdissection-TESE has been developed to detect sperm in the testicles of men who have poor sperm production.
Non-obstructive azoospermia (or abnormal sperm production) is a very common cause of male infertility. Here at euroCARE IVF, expert fertility doctors recommend microsurgical testicular sperm extraction (microTESE Cyprus) for non-obstructive azoospermia.
Azoospermia, or lack of sperm in the semen causes infertility in 10% of men. Approximately 60% of these cases are due to non-obstructive azoospermia (NOA) — a failure of the testes to produce sperm due to intrinsic impairment or elevated HCG levels.
Micro TESE is currently one of the most popular sperm retrieval procedures for men with NOA.
Successful sperm retrieval with Micro TESE has been reported in up to 63% of men. Conventional and more limited sperm retrieval procedures have success rates of 20% (percutaneous testicular biopsies) to 45% (open testis biopsies).
Factors that impact the success of sperm retrieval in men with NOA include: age, FSH, testicular size, genetic analysis, Klinefelter syndrome, cryptorchidism or varicocele and histopathology on diagnostic biopsy.
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.
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.Resources:
https://bacandrology.biomedcentral.com/articles/10.1186/2051-4190-23-5
https://healthcare.utah.edu/fertility/treatments/tese.php
https://www.researchgate.net/figure/Microsurgical-Testicular-Sperm-Extraction-Micro-TESE-Operating-microscope-and_fig3_51813592