Testicular Sperm Aspiration
IVF (In Vitro Fertilization), TESA stands for Testicular Sperm Aspiration. It is a surgical procedure used to retrieve sperm directly from the testicles in cases where sperm is not present in the ejaculate, a condition known as azoospermia. TESA is typically performed in conjunction with IVF or ICSI (Intracytoplasmic Sperm Injection) to assist couples experiencing male infertility issues.
Here’s a detailed explanation of the TESA procedure, its purpose, steps, indications, and considerations: Purpose of TESA
The primary goals of TESA are:
1. Sperm Retrieval: To obtain viable sperm directly from the testicles in men who have no sperm in their ejaculate due to blockages or other factors affecting sperm transport.
2. Assisted Reproduction: To provide sperm for use in assisted reproductive technologies like IVF or ICSI, enabling fertilization of the partner’s eggs.
3. Diagnosing Azoospermia: To determine the cause of azoospermia by examining the presence or absence of sperm within the testicular tissue.
Indications for TESA
TESA is indicated in various cases of male infertility, including:
1. Obstructive Azoospermia:
A condition where sperm is produced in the testicles but is blocked from reaching the ejaculate due to obstructions in the reproductive tract, such as vas deferens blockage or vasectomy.
2. Non-Obstructive Azoospermia:
A condition where there is impaired or absent sperm production in the testicles due to hormonal imbalances, genetic factors, or testicular failure.
3. Failed Vasectomy Reversal:
In cases where a vasectomy reversal is unsuccessful in restoring sperm to the ejaculate, TESA may be used to obtain sperm for IVF or ICSI.
4. Congenital Absence of Vas Deferens:
Men with congenital absence of the vas deferens, often associated with cystic fibrosis, can have sperm retrieved directly from the testicles.
5. Other Male Infertility Factors:
In instances where conventional sperm retrieval methods are unsuccessful, or there are severe sperm production issues, TESA provides an alternative method for obtaining sperm.
The TESA Procedure
Testicular Sperm Aspiration (TESA) involve the following step:
Step 1: Pre-Procedure Preparation
Consultation and Evaluation: A thorough medical evaluation is conducted to determine the cause of azoospermia and assess suitability for TESA.
Informed Consent: Patients are informed about the procedure, risks, and potential outcomes. Consent is obtained before proceeding.
Anesthesia: TESA is typically performed under local anesthesia or mild sedation to minimize discomfort. In some cases, general anesthesia may be used, especially if combined with other procedures.
Step 2: Sperm Aspiration:
Needle Desire: A fine needle is embedded straightforwardly into the gonad through the scrotal skin.
Microscopic Examination: The aspirated material is immediately examined under a microscope by an embryologist or andrologist to assess the presence of sperm.
Sperm Collection: If sperm is found, it is collected and prepared for use in IVF or ICSI. Multiple aspirations may be performed to increase the chances of retrieving viable sperm.
Step 3: Post-Procedure Care
Recuperation: The method is negligibly intrusive, and patients can as a rule return domestic the same day.
Pain Management: Some discomfort, bruising, or swelling may occur at the aspiration site, but these symptoms are generally mild and can be managed with over-the-counter pain relievers.
Follow-Up: Patients are scheduled for follow-up appointments to monitor recovery and discuss the next steps based on the procedure’s outcome.
Considerations and Alternatives
TESA is one of several techniques available for sperm retrieval. Other methods include:
1. Percutaneous Epididymal Sperm Aspiration (PESA):
Strategy: Comparative to TESA, PESA includes needle yearning of sperm from the epididymis or maybe than the gonad.
2. Microsurgical Epididymal Sperm Aspiration (MESA):
Method: A more invasive surgical technique that involves the use of a microscope to retrieve sperm from the epididymis. MESA is often used when PESA is unsuccessful or when a higher yield of sperm is desired.
3. Testicular Sperm Extraction (TESE):
Method: A surgical procedure that involves making a small incision in the testicle to extract tissue and isolate sperm. TESE is often used in cases of non-obstructive azoospermia.
4. Microdissection TESE (Micro-TESE):
Method: An advanced form of TESE that uses a surgical microscope to identify and retrieve sperm from tiny areas of sperm-producing tissue, offering higher success rates in non-obstructive azoospermia.