Surgical Retrieval of Sperm (PESA / TESE)

Percutaneous Epididymal Sperm Aspiration (PESA)- The use of sperm that is not ejaculated in conjunction with intracytoplasmic sperm injection has been a well-established procedure for couples who have male partners with azoospermia who wish to produce biological offspring. There are surgical techniques that have been developed to remove spermatozoa from epididymides, as well as the tests of these patients.

The procedure to retrieve sperm (SR) is determined by the type of azoospermia which may be obstructionary or non-obstructive. It is also based on the preferences of the surgeon in charge and their expertise. Obstructive azoospermia (OA) is caused by the difficulty in detecting spermatozoa in the urine of the post-ejaculate as well as the ejaculate following centrifugation due to the obstruction to the bilateral seminal ducts.

Therefore, in these instances, Percutaneous Epididymal Sperm Aspiration is performed. We have had good results using PESA and can store the additional sample in a freezer for use in the future.

Testicular Sperm Extraction (TESE)- The extraction of the testicular tissues (Fig 12) to search for sperm and isolation is usually done in PESA unsuccessful patients or confirmed that azoospermia obstruction is a problem. In the case of conventional TESE, an open surgical biopsy procedure is used to extract the testicular tissues without the assistance of optical magnification. This is a daycare and minimally invasive process.

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