A Man’s fertility potential relies on the quality and quantity of his sperms. If in his semen analysis the ejaculate is low or if the sperms are of poor quality or even if no sperms are found (Azoospermia) then it is difficult to lead to pregnancy.
The incidence of male infertility is rising with an incidence of about one in five infertile couples. It is estimated that one in 20 men has fertility problem with low number of sperms in his ejaculate. About one in every 100 men has no sperms in his ejaculate , a condition which is referred to as Azoospermia.
Men with Azoospermia are candidates for sperm aspiration as a part of their in vitro fertilization procedure. Multiple samplings are taken from testicular tissue, as the sperms might be present in some but not all parts of the testes.These samplings can be done by these procedures:
TESA: Testicular sperm aspiration. A fine needle is passed through the skin of the scrotum into testis in order to extract sperm tissue. This is performed multiple items in different parts of testes. The procedure can be done under local anaesthesia or general anaesthesia. There is no cut or stitch.
TESE: Testicular sperm extraction, which is a surgical biopsy of the testis. It is done in operating room under local or general anaesthesia. It involves making a small incision and removing a piece of testicular tissue in order to obtain sperm.
MICROTESA: Microsurgical testicular sperm extraction refers to a procedure that is performed to precisely remove a small volume of testicular tissue with active areas of sperm production. Micro TESA is done with the help of an advanced microscope with powerful magnification unger General anaesthesia. It improves the sperm yield when compared to other methods of sperm production. It also reduces the incidence of vascular injury and maximizes the yield of spermatozoa.
The sperms retrieved are use for ICSI (intracytoplasic sperm injection) procedure and the testicular tissue can be cryopreserved for later use in ICSI.
If sperms are not retrieved in microtesa then the testicular tissue can be sent for histopathlogical examination to confirm the diagnosis.