MESA, TESE methods

The MESA method is intended for men suffering from a vas deferens obstruction (obstructive azoospermia), i.e., the obstruction of a tube that enables the transport of the sperm from the testicle to the urethra during ejaculation. Spermatozoa are usually created but cannot penetrate the cap in the urinary tract. This situation can occur as a result of inflammation, reproductive organ injuries, sterilization, or it can be a congenital growth defect often due to genetic predisposition.

The TESE method is appropriate for the non-obstructive forms of azoospermia. Testicles usually do not produce mature and functional sperm cells. In such cases, it is sufficient for the man to have a sufficient number of undeveloped sperm cells in the seminiferous tubules of the testicle.

Gathered sperm cells do not possess the required motility. Therefore, it is necessary to perform the ICSI method (injecting the sperm into the egg) in the artificial insemination program. The sperm can also be cryopreserved (stored in very low temperatures) and used in other IVF cycles.

Following correctly performed smear and acquisition of enough suitable sperm cells, the success rate does not differ from the standard ICSI (injection of sperm into the egg), which is about 30-45%. If the suitable sperm cells are not found by any of the methods mentioned above, sperm cells of an anonymous donor can be used to fertilize the egg.

APPROACH TO SPERM RETRIEVAL USING THE MESA TECHNIQUE

The procedure is performed under general anesthesia by retrieving sperm cells from the epididymis. Then, the epididymis is magnified by 8-15 times and examined for expanded tubuli, which can be filled with spermatic liquid. Next, the liquid is extracted from the tubuli and immediately transported to the laboratory, where it is evaluated under the microscope for the presence of sperm cells, their quantity and quality. Aspiration of the sperm liquid is performed repeatedly from different areas until sufficient quantities of sperm cells is reached for artificial insemination.

APPROACH TO SPERM RETRIEVAL USING THE TESE TECHNIQUE

The procedure is performed under general anesthesia by retrieving sperm cells from the testicle. The testicles are observed for areas with milky white-colored tubuli, which usually contain sperm at different developmental stages. This area is then removed from the testicle and examined in the laboratory for the presence of sperm cells, their quantity and quality.

PREPARATION FOR THE PROCEDURE

No special preparations are necessary for the procedures. The procedure lasts about one hour. The patient is discharged after approximately a 3-hour recovery period (waking up, full stabilization, and post-procedure bed rest).