Testicular Sperm Aspiration (TESA)

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated. This is done for azoospermia patient.

Azoospermia can be caused by an abnormality or blockage in the epididymis or the vas deferens. This is obstructive azoospermia. In these cases, sperm are being produced in the testes, but they just can’t get out during ejaculation.

TESA is done by using surgical procedures to extract sperm from the epididymis or to dissect it out of tubules from the testis can be an effective. TESA involves passing a fine needle through the skin directly into the testes and retrieving a small number of the somniferous tubules themselves. It is done with local anesthesia in the operating room.

 The tubules are collection in solution and processed by embryologist in IVF lab. This tissue TESE under laminar flow and examine by microscope to check the sperm presence. If, this tissue contain sperm then it will be kept in incubator for 1 hour. After than via ICSI needle one sperm will be injected in oocyte for fertilization. If, this tissue contain no sperm then physician will extract another tissue and still sperm is not presence than egg will be fertilized by donor semen. This is already counsel to the patients.

The number of sperm retrieved through TESA is usually very low compared to the number present in an ejaculate, so the sperm usually injected via ICSI for fertilization. IVF treatment using TESA sperm is a regular procedure and it has good success rate.

Success rates with conventional and more limited sperm retrieval procedures have been reported to be 20% with percutaneous testicular biopsies and up to 45% with open testis biopsies. Successful sperm retrieval has been reported in up to 63% of men undergoing micro-TESE.

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