Sperm can be retrieved directly from the testis rather than from the ejaculate. These procedures are often called TESA (testicular sperm aspiration), TESE (testicular sperm extraction) or PESA (percutaneous epididymal sperm aspiration) or Micro-TESE. Micro dissection TESE also called micro TESE or m Tese
Microdissection Testicular sperm extraction is a surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate, due to failure of the testis (non obstructive azoospermia) It is a surgical biopsy of the testis where an advanced operating micro dissecting microscope is used to pinpoint the tissue to be removed. This aims to cause less damage to the structure inside the testicle, and to therefore have fewer after effects such as blood supply problems caused by tiny blood vessels being cut. It also appears to increase the number of sperm that can be retrieved.
Advantage of Micro TESE over TESE includes:
- Higher sperm retrieval rates
- Reduced acute post-operative complications
- Fewer chronic changes to testicular function
- Fewer complication seen on ultrasound
In our unit we first attempt to retrieve sperms by TESA ,If that fails to get sperms , we then do mapping and if still sperms are not obtained we resort to micro tesa . Alternately , if the patients has failed to get sperms on TESA outside , we would go straight for doing micro tese .