Finding Solutions For Male Infertility

Roughly a third of all infertility cases in the United States are caused by male infertility. Meanwhile, another third of all cases are caused by both female and male infertility. The remainder is attributed solely to reproductive issues with the woman. For most male infertility cases, a central issue is sperm quality or quantity. Without enough viable sperm released inside the vagina, fertilization is unlikely to occur. Thankfully, assisted reproductive technology (ART) can help.

TESA vs TESE: Can Sperm Extraction Help With Severe Male Infertility?

How sperm quality impacts fertility

The main factors that can impact sperm quality include quantity, motility, and structure. Low sperm count means that a man ejaculates less than 15 million sperm per 1ml of semen. Since the vagina can be a hostile environment for semen, a man with low quantity may struggle to naturally get a woman pregnant. Meanwhile, motility refers to movement. A man has poor motility when less than 40% of the sperm in an ejaculate sample are moving. Finally, structure refers to the shape of the sperm and can reflect deformities that might point to underlying deoxyribonucleic acid (DNA) damage.

When to consider sperm retrieval

Most people think of ART procedures for sperm retrieval as a solution solely for men with known infertility issues. However, other special circumstances exist where such options may be necessary. For example, if a man previously underwent a vasectomy, and wants to have a child, but doesn’t want to reverse the procedure, ART is a viable solution. In particular, 2 types of sperm retrievals can be performed for men that have undergone a vasectomy or have a known sperm quality deficiency. Depending on the specific issue, a man may opt for testicular sperm aspiration (TESA) or testicular sperm extraction (TESE) to achieve pregnancy.

When TESA makes sense

Testicular sperm aspiration is a popular option for men with azoospermia, a lack of sperm in the ejaculate, or a known physical blockage preventing sperm from reaching the penis. Previous vasectomy patients are excellent candidates as the procedure allows for a specialist to extract sperm directly from the testes. TESA is typically treated as an outpatient procedure where local anesthesia is given before a needle is used to retrieve the sperm.

When TESE is better

Testicular sperm extraction is slightly different than TESA because the procedure is a bit more invasive. For this sperm extraction, a man will be admitted to a hospital and given general anesthesia. While the patient is under sedation, a surgeon will make an incision in the testis where the tubules will be examined. First, the surgeon will confirm that sperm are present and then extract a sample.

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