What are surgical sperm retrieval methods?
All these procedures can be performed either under local or general anesthesia. General anesthesia is usually preferred for paitent comfort. They are all daily outpatient surgical procedures. The procedure lasts around 10 minutes to half an hour. The patient can get back to daily activities after the procedure. The procedure is performed at the IVF center and sperms are searched simultaneously under microscope. Once sperm is obtained, the procedure is ceased.
PESA: Percutaneous Epidydimal Sperm Aspiration.
A fine needle is inserted to the epididyms and sperms are aspirated. Testes is not opened surgically.
PTSA: Percutaneous Testicular Sperm Aspiration.
A fine needle is inserted to the testicles to aspirate sperms.
TESE: Testicular sperm extraction.
Testicles and tunica albuginea are opened surgically via a small incision. Small biopsies are obtained from the testicles.
Micro TESE: Microscopic Testicular sperm extraction..
Testicles and tunica albuginea are opened surgically via a small incision. Testicles are examined under microscope and biopsies are obtained accordingly. This procedure is thought to be less harmful to the testicles.
What is the chance of sperm retrieval?
In almost all of obstructive azospermia and half of nonobstructive azospermia cases, sperm can be obtained.
Once sperm is obtained, can they be freezed for future use?
This can work for obstructive azospermia cases. But, the success rates are significantly lower for nonobstructive azospermia cases.
How many times a man can undergo these procedures?
For obstructive azospermia cases, up to 7 successful procedures have been reported. For nonobstructive azospermia cases, if the first TESE revealed sperms, up to 6 other successful TESE have been reported. Pregnancy rates are similar with recurrent TESE applications.
What should be done for nonobstructive azospermia patients whose first TESE did not reveal sperms?
Chance of getting sperms in a patient with a first negative TESE is around 25%. Among our patients, this rate has been found around 5%. This decreased rate is probably due to a more extensive first TESE.
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