Micro TESE or Microsurgical Sperm Retrieval is the retrieval of sperm from the testicle. In this procedure, an incision is made in the scrotum through which both testicles can be seen. The doctor then conducts a thorough examination of several areas of the testicles to check for any abnormalities and in order to identify the presence of sperm. This procedure is usually conducted only if all other Surgical Sperm Retrieval (SSR) techniques have been unsuccessful.
PESA or Percutaneous Epididymal Sperm Aspiration is a Surgical Sperm Retrieval (SSR) procedure where sperm is obtained by gentle suction after a fine needle is inserted into the epididymis, above the testis. This procedure is usually conducted when the ejaculate has no sperm because of an injury, blockage or previous surgery.
PESA is usually performed prior to starting an IVF cycle, and the extracted sperm is frozen and stored for use in conjunction with Intracytoplasmic Sperm Injection (ICSI) during the IVF cycle.
If your semen analysis shows that you do not have sperm within your ejaculate, there are different methods of surgically retrieving the sperm, which is sometimes referred to as Surgical Sperm Retrieval (SSR).
Testicular Sperm Aspiration (TESA) and Testicular Sperm Extraction (TESE) are both methods of SSR where sperm is retrieved from the tissue in a man’s testis. TESA uses gentle suction through a small needle while TESE involves taking a larger tissue sample from an incision. Both procedures are minor day surgeries and should be done before beginning an IVF cycle.
Sperm banking or freezing is a method of preserving sperm cells, and is especially useful for men who want to delay parenthood until a later stage. It is also useful for men who plan to undergo certain types of medical treatments (chemotherapy and radiation for instance) that could impact their sperm quality. Sperm may also be frozen as a backup option during a couple’s fertility treatment.
Semen is analysed after being collected through ejaculation or surgically assisted retrieval like TESA or TESE, before the sperm cells are frozen in a laboratory. During an Intrauterine Insemination (IUI) or In-Vitro Fertilisation (IVF) procedure, the frozen sperm samples are used.
There are a number of reasons explaining the need for donated sperm. These include:
Low sperm count in the partner’s semen due to various reasons such as injury, vasectomy or other male infertility factors, cancer treatment, etc.
An inherited disease, such as Haemophilia or Duchenne’s Muscular Dystrophy, putting the life of a resulting baby at risk
Incompatible blood types, if the female partner is Rhesus (Rh) sensitised and the male partner is Rh positive, the pregnancy is potentially problematic.
In the case of donor eggs, while chances of pregnancy are similar to that of conventional IVF, the donor’s age is a key factor that impacts success rates.