What is Azoospermia?
The absence of sperm in a sperm analysis is referred to as azoospermia. Azoospermia can have numerous underlying causes, generally stemming from either the testes’ inability to produce sperm or blockages in the sperm ducts, preventing sperm from appearing in the semen. When appropriate medical and surgical methods fail to address the underlying cause, the micro-TESE (Microscopic Testicular Sperm Extraction) method can be employed to retrieve sperm for use in assisted reproductive techniques. Micro-TESE is a procedure performed in an operating room under local or general anaesthesia, where the testicles are opened, and the tubules carrying semen are extracted using a microscope. The testicular tissues obtained are then subjected to laboratory processes to obtain sperm for use in in vitro fertilization (IVF) procedures. With the exception of very rare conditions (such as Sertoli cell-only syndrome), micro-TESE has a high success rate in retrieving sperm.
What is the Difference Between TESE and Micro-TESE?
In the micro-TESE procedure, unlike TESE, the process of retrieving sperm from the testicles is performed under a microscope. This allows for the more successful identification of structures called tubules that contain sperm and enables precise, small-scale biopsies from suitable locations.
Are There Alternative Techniques for Retrieving Sperm Besides TESE?
Especially in cases where it is believed that there is no problem with sperm production in the testes, and the issue lies in the ducts that transport sperm either congenitally or acquired, sperm can be retrieved through procedures known as TESA or PESA (for example, in patients with cystic fibrosis where the cord is congenitally absent or individuals who have undergone voluntary sterilization procedures like vasectomy). These procedures, known as TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration), are simpler and involve less invasive measures compared to the TESE procedure.
- TESA (Testicular Sperm Aspiration): The process of using a needle to aspirate sperm from the testes.
- PESA (Percutaneous Epididymal Sperm Aspiration): The procedure of using a needle to aspirate sperm from the epididymis, a canal in the testis.