There are many reasons why sperm retrieval may be necessary. It can be after a vasectomy, or if there is a blockage of sperm or if a male is simply not making enough sperm. Dr. Gittens utilizes a variety of retrieval techniques to obtain sperm for in-vitro fertilization (IVF). He will discuss with you the approach that is right for your situation.
Percutaneous Aspiration of Sperm
Percutaneous retrieval of sperm is done with a fine needle. This can be done in the office with only local anesthetic. It can also be done in an IVF center prior to or at the same time as In vitro.
Microscopic Epididymal Sperm Aspiration
Another form of retrieving sperm is called microscopic epididymal sperm aspiration or MESA. During the MESA, sperm is directly taken from a single isolated epididymal tubule under a surgical operating room microscope. After 10-20 million sperm are obtained, the epididymal tubule is closed with multiple microscopic sutures. The procedure avoids the blind passage of a retrieval needle into the epididymis and testicle. The procedure can be performed in advance of in-vitro so the couple can be assured the male has adequate sperm production.
Testicular Sperm Extraction and Microscopic Testicular Dissection
Azoospermia is a condition where there is no sperm seen on the semen analysis. This can be caused by a variety of reasons. Regardless of the cause, Dr. Gittens may perform either a testicular sperm extraction (TESE) or microscopic dissection of the testicles. The TESE is performed by numbing the testicles then making a small incision into the testicle and removing a piece of testicular tissue to be used for in-vitro fertilization.
The microscopic testicular dissection is performed when the TESE is unsuccessful in identifying sperm or if the TESE is unlikely to yield high results. This procedure is performed in a general operating room and the patient is put to sleep. The testicle is carefully opened and with an operating room microscope, the testicle is meticulously scanned and sampled for areas of sperm production in the tissue. These areas are then retrieved and used for IVF. For the best results, a microscopically trained urologist that specifically treats male fertility should perform this procedure.