Male infertility can take many forms. Even men who produce viable sperm can be infertile. For a variety of reasons in some men, viable sperm is produced but none is found in the seminal fluid. In other cases, medical conditions, disease or injury can render an otherwise fertile man incapable of ejaculating sperm. Today, microsurgical techniques allow surgeons to retrieve viable sperm sufficient to use for conception, simply and effectively. Microsurgical epididymal sperm aspiration (MESA) and Testicular Sperm Extraction (TESE) are two of the leading sperm retrieval procedures. Before any such procedure is considered, a semen analysis is performed to see if viable sperm are present in the semen. If no sperm are present, a condition referred to as “azoospermia,” an attempt can be made with microsurgical techniques to test for the presence of viable sperm and retrieve them for use in conception through in vitro fertilization. Whatever sperm retrieval technique is selected, the goal is always to obtain the greatest number and most viable sperm while minimizing damage to the reproductive tract.
Microsurgical epididymal sperm aspiration (MESA) is a process of extracting sperm from the testicles, usually employed for men who make viable sperm in the testes at a normal level of production, but do not have sperm in their seminal fluid. This form of male infertility is due to obstruction(s) in the reproductive tract, as seen in men who have had a vasectomy, or the vas deferens may be entirely absent due to a genetic anomaly. Sperm harvested via MESA is almost always used for in vitro fertilization (IVF).
Testicular Sperm Extraction (TESE) can be used both to assess the degree of sperm production in the setting of azoospermia as well as to obtain sufficient tissue for sperm extraction, either for immediate use or to be preserved as a frozen specimen (cry preserved) for IVF with ICSI. The procedure typically involves a single opening in one or both testes and can be performed on an outpatient basis.
We perform both of these procedures at the Center for Vasectomy, Vasectomy Reversal and Male Fertility in Millburn, New Jersey. Find out if these procedures can make a difference for you. Contact us today to schedule a consultation with Dr. Eric Seaman, our founder.