Surgical Sperm Retrieval
What is Azoospermia? Microinjection is the most important development after IVF between assisted reproductive treatments. A few years after the first microinjection and the birth of the born baby, revolutionized sperm searching process began to be used. There was hope for thousands of men who could not have children all around the world. What is […]
What is Azoospermia?
Microinjection is the most important development after IVF between assisted reproductive treatments. A few years after the first microinjection and the birth of the born baby, revolutionized sperm searching process began to be used. There was hope for thousands of men who could not have children all around the world.
What is azoospermia?
Lack of sperm in a man’s semen is called azoospermia. Azoospermia may be due to different causes. Some of this depends on the obstruction of the sperm channels. In such a case, there is no production of sperm in the testicles. However, the existing sperm cannot be discharged with the menu due to obstruction in the channels. In this case, the absence of sperm due to obstruction (obstructive azoospermia) is mentioned. In cases of azoospermia due to obstruction, small pieces are taken by entering into channels or testis which are obstructed by a thin needle. The rate of finding sperm in these parts is close to 100%.
In non-obstructive conditions (non-obstructive azoospermia), sperm production is absent or there is a very limited number of specific areas. The underlying cause of non-obstructive azoospermia may be genetic, as well as adolescent infections. In such a case, a testicular biopsy is very useful in guiding treatment.
What is the success rate of surgical intervention?
There are thousands of small tube-like structures in the testis tissue. In these structures, sperm production continues in different stages. Some tubules do not have any production, some may have a small amount of sperm. Here is the logic underlying the methods of surgical sperm exploration. When a large number of parts from different parts of the testis are examined, sperm cells can be found. In this method, called TESE, the possibility of finding sperm varies between 25 – 60% depending on the underlying cause. The highest success is achieved in cases of hypospermatogenesis in which sperm production is very low, but in cases with genetic disorders, the chance is minimal.
In an azoospermia case, the presence of sperm in previous trials does not guarantee that sperm will always be found in subsequent trials. But most times we get success. Similarly, in those who have not previously found any sperm, the biopsy results show that there is a possibility of finding sperm in a new trial.
Once the sperm is found, the fact that it is found in the testis or meaning does not have a significant effect on the success rates of the microinjection. In other words, ingestion of the sperm from the semen, channels or directly from the testis does not change the pregnancy rates and results.
How is surgery performed?
This procedure is called percutaneous epididymal sperm aspiration (PESA) when it is taken from the channels by sperm needle. Percutaneous testicular sperm aspiration (PTSA). It is called testicular sperm extraction (TESA). While PESA and PTSA can be performed with local anesthesia, TESA is usually performed under general anesthesia.
The procedure lasts about 15 to 45 minutes, and the person may return to normal life the next day.
In case of absence of spermatozoa, the path to be followed depends on the biopsy result. If there is no chance of finding a sperm in a new trial, then applying to sperm banks is the only method available. In such a case, a new trial can be done several months later.