There are many different methods of sperm extraction. You will be able to consult with our surgeons in order to figure out which form suites you best.
One form is Micro-Epididymal Sperm Aspiration (MESA) which is a surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate.
Under the care of a consultant urologist, MESA is a minor theatre procedure carried out on an outpatient basis under local anesthesia.
Sperm are retrieved from the epididymis. This is the area adjacent to the testes where sperm are stored between production and ejaculation. Sperm extracted in this way can be used to achieve fertilization of eggs in the laboratory.
Sperm retrieval for azoospermia (PESA/TESE)
Azoospermia is a condition where no sperm are present in the fluid a man ejaculates. A man might have azoospermia because:
- Of a blockage in the connecting passages from the testicles - called obstructive azoospermia.
- Very few sperm are being produced in the testicles - called non-obstructive azoospermia.
- Only one sperm is needed per egg for ICSI. We can use Percutaneous Epididymal.
Sperm Aspiration (PESA) to obtain small numbers of sperm directly from the epididymis, which is the beginning of the outlet tube from the testicle. If PESA is unsuccessful, sperm may be obtained directly from the testicle using
Testicular Sperm Aspiration (TESA) or Testicular Sperm Extraction (TESE) .These procedures can be done before starting a treatment cycle or on the day of the egg collection. The doctor will discuss with you the reason for the timing, depending on the cause of your azoospermia and whether sperm has previously been found.
Sperm is obtained in most cases if it is being produced in the testicle but there is an obstruction preventing the sperm from appearing in the ejaculate, usually due to previous surgery, infection or inflammation. There is about a 25-30% chance of finding mature sperm, which is suitable to freeze and use in treatment, if there has been a problem with the development of the sperm producing cells within the testicles (non obstructive azoospermia). If we suspect obstructive azoospermia the procedure is done under local anaesthetic, which is medication that 'freezes' the area so it is pain free. You will also be given sedation, which is medication that can relax you and make you feel sleepy. You might find the leaflet, Having an anaesthetic , useful. If you do not already have this, please ask us for a copy. Sometimes the sedation can make you feel sick.
It is therefore very important that you do not eat or drink for six hours before PESA or TESA/TESE. The sedation can also affect your reasoning, reflexes, judgement, coordination and skill for 24 hours after the procedure. You must be accompanied home by another adult who has not had sedation. This is particularly important if your procedure is on the same day as your partner's egg collection. For 24 hours after the sedation,..br />
- Stay alone - a responsible adult must stay with you during this time.
- Drive any vehicle, including a bicycle.
- Operate any machinery
- Attempt to cook, use sharp utensils or pour hot or boiling liquids
- Drink alcohol
- Take sleeping tablets
- Make any important decisions or sign any contracts.
If sufficient sperm is obtained from PESA or TESA/ TESE, it may be possible to freeze it for future use.
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