One
form is Micro-Epididymal Sperm Aspiration (MESA) which is a surgical
sperm retrieval procedure used in fertility treatment for men who have
no sperm in their ejaculate.
Under
the care of a consultant urologist, MESA is a minor theatre procedure
carried out on an outpatient basis under local anesthesia.
Sperm
are retrieved from the epididymis. This is the area adjacent to the
testes where sperm are stored between production and ejaculation. Sperm
extracted in this way can be used to achieve fertilization of eggs in
the laboratory.
Sperm retrieval for azoospermia (PESA/TESE)
Azoospermia is a condition where no sperm are present in the fluid a man ejaculates. A man might have azoospermia because:
Sperm Aspiration (PESA)
to obtain small numbers of sperm directly from the epididymis, which is
the beginning of the outlet tube from the testicle. If PESA is
unsuccessful, sperm may be obtained directly from the testicle using
Testicular Sperm Aspiration (TESA) or Testicular Sperm Extraction (TESE) .
These
procedures can be done before starting a treatment cycle or on the day
of the egg collection. The doctor will discuss with you the reason for
the timing, depending on the cause of your azoospermia and whether
sperm has previously been found.
Sperm
is obtained in most cases if it is being produced in the testicle but
there is an obstruction preventing the sperm from appearing in the
ejaculate, usually due to previous surgery, infection or inflammation.
There is about a 25-30% chance of finding mature sperm, which is
suitable to freeze and use in treatment, if there has been a problem
with the development of the sperm producing cells within the testicles
(non obstructive azoospermia). If we suspect obstructive azoospermia
the procedure is done under local anaesthetic, which is medication that
'freezes' the area so it is pain free. You will also be given sedation,
which is medication that can relax you and make you feel sleepy. You
might find the leaflet, Having an anaesthetic , useful. If you do not
already have this, please ask us for a copy. Sometimes the sedation can
make you feel sick. It is therefore very important that you do not eat
or drink for six hours before PESA or TESA/TESE. The sedation can also
affect your reasoning, reflexes, judgement, coordination and skill for
24 hours after the procedure. You must be accompanied home by another
adult who has not had sedation. This is particularly important if your
procedure is on the same day as your partner's egg collection. For 24
hours after the sedation, please do not:
