PESA, MESA , TESE - Sperm Retrieval
Fertility is among the most emotionally traumatic challenges that a couple may face. It is important to do preliminary tests to investigate the cause of infertility and upon whom the infertility lies.
PESA, MESA or TESE are used to help couples where it is the male partner who has infertility issues. In these cases the partner may either have a low sperm count or low sperm mobility. In other cases men might have no sperm present in the semen when he ejaculates. During PESA, MESA and TESE, all procedures are used with ICSI to ensure fertilization.
PESA is a procedure where a needle is inserted in the epididymis (a narrow tube that connects the efferent ducts depart to the rear of each testicle to the vas deferens) to extract seminal fluid. The fluid is then analyzed in the laboratory and with the guidance of the doctors, the embryologist selects the healthiest sperm and fertilizes the egg with ICSI. This procedure can be performed under general anesthesia or local anesthesia with sedation. At Dogus IVF Centre, we prefer to use local anesthesia with sedation as there are less complication, and recovery and faster.
TESE means microsurgery Testicular Sperm Extraction. It is where a small sample of testicular tissue is extracted from the testicles with a fine needle. Embryologists then analyze the tissue in the laboratory and select the sperm to be used for ICSI fertilization. This procedure is the most common of the three and is relatively fast, taking only an average of 15 minutes. It is usually used for men who have had vasectomy. Local anesthesia is used for the procedure. Our nurses will manage an anti-pain reliever in case of need.
MESA is a procedure for the recovery of sperm from the epididymis in men who have a diagnosis of vas deferens blocked. This procedure is usually done by hand under general anesthesia. Men who are in need of MESA, usually those with low quality sperm, proceed to normally having ICSI done immediately to promote the chances of fertilization. This is done at Dogus IVF Clinic by Dr. Sevket.
The medical term for the absence of sperm is Azoospermia. There are two types of Azoospermia:
Obstructive Azoospermia – In this case sperm is created, but cannot be mixed with the rest of the ejaculatory fluid due to a physical obstacle.
Non-obstructive Azoospermia – In this case there is a problem with the man’s spermatogenesis, where there is a production or development of mature spermatozoa. This is a condition caused by hyperprolactinemia. (Hyperprolactinemia is a disorder marked by the overproduction of prolactin; one of eight hormones produced by the pituitary gland - in both men and non-pregnant women.)
There are a number of reasons why semen samples may have no sperm present.
Some of them are:
a) A blockage in the tubules that carry sperm from the testicles to the penis.
b) The transporting path between the testicles and the penis failed to fully and maturely develop during puberty thus leading to the sperm not be transported.
c) The production of semen may be low and may be produced in low numbers, thus leading to a difficulty in identifying them in the sample.
d) The male partner may have had a vasectomy which would cause the path from the testicles to the penis that carries the sperm to be disconnected.