During certain instances where there is very little or no sperm present in the ejaculate, Dr. Thompson may discuss the possibility of TESE and MESA procedures. Both testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA) are performed by a specialized urologist in collaboration with our laboratory staff. These surgical sperm retrieval procedures require the patient to undergo local or general anesthesia so the urologist may extract a small bit of testicular tissue and/or epididymal fluid. Promptly after the samples have been recovered, they will be taken to the IVF lab where they will be frozen via advanced cryopreservation methods. This ensures that they are preserved until it’s time for in vitro fertilization and ICSI procedures.
The successful fertilization rates involved with testicular and epididymal sperm are essentially equivalent to those achieved with ejaculated sperm. This state-of-the-art procedure has given those with male factor infertility another option besides sperm donation or vasectomy reversal. Surgically retrieved sperm require direct sperm inject into the egg (ICSI) due to the low numbers of sperm and reduced functional maturity.
Semen Analysis testing as well as a test known as sperm DNA fragmentation testing are available to evaluate male factor infertility. Abnormal results, including low sperm volume, concentration or motility may be addressed with treatment such as intrauterine inseminations or Invitro Fertilization.