When men think about infertility, the first thing that comes to mind is poor sperm count, volume, or motility. Yet, there are cases where the man has azoospermia. With azoospermia, there is little to no sperm in the ejaculate. Azoospermia can happen due to a blockage in the vas deferens or elsewhere along the reproductive tract. Some cases are genetic, hormonal, developmental, or a side effect of medication or disease. For some men, sperm is still present in the testes. Micro-TESE is the best way to access the sperm to perform IVF.
What happens during micro-TESE?
Mirco-TESE is a microscopic testicular sperm extraction. This is a surgical procedure to remove the sperm samples needed for reproduction carefully. Micro-TESE is very delicate and performed by highly skilled doctors. First, the patient is placed under general anesthesia. The testicle is opened using small incisions and then inspected with a microscope. Once the sample is found, the doctors will aspirate the specimen for future use.
Micro-TESE takes time
Micro-TESE is a lengthy procedure, taking as much as 4 hours to complete. The team would look at different areas of the testicles for possible sperm production. The length of time depends on the size of the testicles and the number of sperm present. The procedure takes time to reduce any damage to the testis. Some clinics perform multiple biopsies first before micro-TESE.
Hormone medication may help
Some clinics may recommend hormone medication before the procedure. Studies show that clomiphene citrate can increase sperm count. This drug increases the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). While there is no guarantee, studies show that hormone treatment can improve the procedure’s success.
Drawing a blank
Even a procedure as detailed as micro-TESE has limitations. In rare cases, the medical team can fail to locate sperm. If this happens, the patient must discuss the next steps with their partner. The best scenario is to use donor sperm from a family member or donor clinic.
Micro-TESE leads to ICSI
Once the surgical team acquires viable sperm samples, the fertility clinic can move on to IVF. The embryologist may use intracytoplasmic sperm insemination (ICSI) to improve the chances of success. The team uses a tiny needle to place a single sperm in the egg. Any remaining sperm are frozen for future use. Micro-TESE shows that all is not lost with severe male infertility. The procedure may take some time and skill, but this can give some men the opportunity to start a family.