There are several reasons a man may need to undergo a sperm extraction procedure. These can include a prior vasectomy or failed vasectomy reversal, anatomic blockage of the reproductive system or to extract sperm directly from the testicle in some severe forms of infertility.
Percutaneous Epididymal Sperm Aspiration (PESA)
Percutaneous epididymal sperm aspiration involves the use of a needle passed through the skin into the epididymal tubules where sperm naturally mature. This procedure can be about 90% effective in men who have a prior vasectomy but the success rate can be significantly lower in men who have no sperm in the ejaculate with unknown cause. Recovery for this procedure can be relatively quick and most men can return to normal duties within 24 to 48 hours. The sperm retrieved from this method is immediately evaluated by an andrologist and the sperm is frozen for use in conjunction with in vitro fertilization (IVF). This procedure is most commonly performed in an advanced reproductive facility.
Microscopic Epididymal Sperm Aspiration (MESA)
Microscopic epididymal sperm aspiration generally follows an unsuccessful percutaneous approach. An incision is made in the scrotum and the testicle is carefully brought to the surface and inspected. The epididymal tubules, where sperm naturally mature, are inspected microscopically. Individual epididymal tubules are then carefully incised and their contents aspirated. The fluid is then inspected microscopically and sperm that is found is preserved. This sperm generally is then used in conjunction with IVF with the help of an advanced reproductive endocrinologist.
Micro Testicular Sperm Exploration (micro-TESE)
Micro testicular sperm exploration is the most extensive sperm extraction procedure and is only performed by specially trained male fertility specialists. This procedure often follows the microscopic epididymal sperm aspiration and involves an incision in the testicle itself and a careful microscopic exploration that can last several hours. The cells responsible for producing sperm are extracted and inspected microscopically to look for evidence of mature sperm production. This sperm can be frozen and used in conjunction with IVF.
Dr. Mistry has performed more advanced sperm aspiration procedures than anyone in Austin in the last 10 years. We use several different facilities depending on where you are referred.