Extracting Hope From Male Infertility
Severe male-factor infertility is often linked to sperm production issues. For instance, men with a severely low sperm count can struggle with fertility. Men with azoospermia, known as an absence of sperm in the ejaculate, are unable to conceive naturally. This may have signaled the end for men trying to have a family with a biological link. However, there is hope with assisted reproductive technology (ART) strategies. Before ART, sperm extraction is a necessary step for cases of severe sperm count challenges. Testicular sperm aspiration (TESA) or testicular sperm extraction (TESE) are surgical procedures used to acquire the necessary sperm samples.
Extracting sperm with minimally invasive TESA
ART techniques like in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are used to treat severe infertility. However, a sperm sample is necessary to establish a biological link with the child during embryo production. In many cases, sperm is present in the testicles but absent in the ejaculate. Testicular sperm aspiration uses a minimally invasive procedure to retrieve sperm directly from the testicles. A surgeon uses a thin needle to extract fluid from the epididymis, a tube that stores mature sperm cells. The sample is then passed to the fertility team to assess and locate all healthy, motile sperm.
Turning to TESE
TESE is an advanced method of sperm extraction that is particularly useful for non-obstructive azoospermia. This surgical procedure is performed with the patient under general anesthesia. The goal is to extract testicular tissue to dig deeper and find sperm cells from sperm-producing regions. A surgeon will make a small incision in the scrotum to access the testicles. Using patented surgical tools, the surgeon will remove tiny samples of the testicles in areas that are known to produce sperm. The samples are safely stored and passed to a fertility laboratory for processing. The surgeon will close the incisions and complete the procedure. At a later time, the laboratory will analyze the samples and extract sperm to continue ART.
Why use TESA vs TESE?
Both TESA and TESE aim to bypass the issues behind severe sperm count issues. Acquiring sperm using these strategies offers an opportunity to fertilize eggs to create embryos with a biological link. TESA is a quick, non-invasive outpatient procedure performed with local anesthesia. The technique is ideal when there is a known obstruction causing azoospermia. Men who had an unsuccessful vasectomy reversal and still want to have children can request TESA. Doctors recommend TESE for non-obstructive azoospermia. Common causes include varicocele, genetic conditions, hormonal challenges, and exposure to certain medications. TESE is more complex but provides a more comprehensive sperm retrieval, with the potential for more sperm.
Make the right choice
A fertility specialist or clinic will present TESA and TESE as options for sperm extraction. The decision depends on the underlying cause of infertility. TESA is a quick, effective method for retrieving sperm if there is a known blockage. TESE, on the other hand, helps with severe sperm quality issues or non-obstructive azoospermia. Time, cost, and patient health influence the right selection. The extracted sample can be then prepared for IVF or ICSI, where a single healthy sperm is necessary to create an embryo. TESA and TESE help men with a severely low sperm count achieve the joys of parenthood.
