Who is it for?
For men with no sperm in the ejaculate (azoospermia). There are two types of azoospermia:
Most frequently due to an absent or blocked vas deferens (the tube connecting the testicle to the penis) resulting in the sperm not reaching the ejaculate. This may occur following vasectomy or in carriers of the cystic fibrosis gene. These patients have a high chance of finding sperm at the time of surgery.
This is due to abnormal sperm production and may occur for a variety of reasons- genetic, testicular failure due to undescended testes, varicocoele. The chance of finding sperm at the time of surgery is very much dependent on the underlying cause.
What does it involve?
There are several methods of surgical sperm retrieval. They are used in conjunction with ICSI treatment.
Percutaneous Epididymal Sperm Aspiration (PESA)
A fine needle is inserted through the skin of the scrotum to aspirate the sperm from the epididymis. The procedure is performed in the clinic under sedation and local anaesthesia.
Testicular Sperm Extraction (TESE)
TESE is generally performed when PESA is unsuccessful. In this procedure, a small incision is made in the scrotum and testis and a biopsy of testicular tissue is taken. This tissue is examined carefully under the microscope for motile sperm, which are then extracted for use in an ICSI cycle. The procedure is performed in the clinic under sedation and local anaesthesia.
Microsurgical Testicular Sperm Extraction (Micro-TESE)
Micro-TESE is a more advanced procedure for men whose basic problem is failure to produce sperm cells. The procedure involves carrying out targeted dissection of tiny tubes within the testicle, which are more likely to contain sperm. A high powered microscope is used during the procedure to distinguish between healthy and unhealthy tissue. The healthy tissue samples are then examined in the laboratory. If viable sperm is found, it is prepared and frozen for use in a subsequent ICSI cycle. Waterstone clinic, together with Dr Ivor Cullen, Consultant Urologist and Andrologist, is proud to have established the first microTESE service in Ireland.