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Male infertility can arise when semen is ejaculated without spermatozoa, which can be caused by various factors such as blocked sperm ducts, congenital sperm duct anomalies, abnormal sperm ejaculation, or the presence of non-viable spermatozoa due to infections like epididymitis.
Sperm Retrieval from Epididymal Sperm Aspiration (PESA)
PESA / TESE at LaVida: Surgical Sperm Retrieval Techniques
Suitable for who?
1. Obstructive Azoospermia:
Men with blockages in the epididymis or vas deferens, which prevent sperm from being ejaculated naturally.
2. Failed Vasectomy Reversal:
Men who have undergone a vasectomy and subsequent reversal surgery that was unsuccessful in restoring sperm flow.
3. Congenital Absence of Vas Deferens:
Some men are born without the vas deferens (the tube that carries sperm from the testicles). PESA can retrieve sperm directly from the epididymis in these cases.
4. Non-obstructive Azoospermia (in certain cases):
In some instances of non-obstructive azoospermia, where sperm production in the testes is impaired but sperm are present in the epididymis, PESA may be attempted to retrieve viable sperm for assisted reproductive techniques like IVF or ICSI.
Testicular Sperm Extraction (TESE) takes tiny slivers of tissues from the testis to extract sperm under a microscope. TESE is a procedure suitable for patients who lack sperm in their semen due to various reasons such as obstructive azoospermia, non-obstructive azoospermia, inflammation of the testicular tubes, absence of sperm in the epididymis, and genetic abnormalities. These is often of low quantity and sometimes immature (spermatid). Sperm are collected and cultured in a laboratory until they mature into fully developed sperm, which are then used for intracytoplasmic sperm injection (ICSI). This process provides patients with a chance to conceive offspring in the future.
Testicular Sperm Extraction (TESE)
As a Backup Option: PESA may also be considered as a backup option in cases where other sperm retrieval methods (such as testicular sperm extraction - TESE) are not feasible or have failed.
Suitable for who?
1. Obstructive Azoospermia:
This condition occurs when there is a blockage in the tubes that carry sperm (epididymis or ejaculatory ducts), preventing sperm from being ejaculated despite normal sperm production in the testes.
2. Non-Obstructive Azoospermia:
In this case, there is no blockage in the tubes, but the testicles do not produce sperm due to issues such as genetic abnormalities or testicular failure.
3. Epididymal Inflammation:
Inflammation of the epididymis can impair sperm transport, leading to a condition where sperm cannot reach the ejaculate.
4. Previous Vasectomy:
TESA can be used to retrieve sperm from the testicles of men who have undergone a vasectomy and wish to have children through assisted reproductive techniques.
5. Genetic Abnormalities:
Conditions such as Klinefelter syndrome or other genetic disorders affecting sperm production may also necessitate the use of TESA to retrieve sperm directly from the testes.
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