It Takes Two To Make A Baby: Diagnosing Male Factor Infertility
Many people hold the mistaken assumption that infertility is always related to female factor infertility. About 1/3 of infertility cases are secondary to male factor infertility. Accessing the cause of infertility is essential to finding the best fertility treatment for a couple. When a specialist examines a semen sample to assess fertility there are four specific factors that are reviewed. Areas that are examined are the amount of the ejaculate, the sperm count, and the shape and movement of the sperm. Results of a sperm analysis are typically available within 48 hours.
Harvesting sperm using MESA
MESA (Microscopic Epididymal Sperm Extraction) is a process in which sperm is collected using a surgical microscope. Under general anesthetic, the doctor uses a microscope to open the tubes in the epididymis in order to harvest sperm. Typically, this technique is used in cases where the man is producing sufficient sperm, but the sperm is prevented from traveling from the penis because of a blockage.
Causes of sperm blockage
Sperm blockage can be caused by a hernia repair with a mesh, a prior vasectomy, immotile cilia syndrome, and cystic fibrosis. Sperm which is harvested from the epididymis is usually better quality than sperm which is harvested from the testicles secondary to maturity time.
Harvesting sperm using TESE
TESE (Testicular Sperm Extraction) is similar to the MESA procedure except, in this case; tissue is extracted directly from the testicles and then examined for sperm. This technique is often used in cases of obstructive azoospermia in which the tube running from the testicle to the ejaculate is blocked. It can also be used in cases of non-obstructive azoospermia to assess the presence of sperm.
TESE is performed using a microscope and requires general anesthesia and small incisions in the testicle to harvest sperm. Depending on the medical condition, in some cases, the testicle may be opened completely to take samples. Any sperm which is found can be used straight away for egg fertilization or frozen for later use.
Multiple options
Male factor infertility has many options available, whether it’s TESA, MESA, MicroTESE or TESE. Couples trying to get pregnant should consider having both male and female factor causes of infertility tested.