The Treatment of Male Infertility at AUUA
There are many factors that attribute to infertility in men, including a low sperm count, a defect or obstruction in the reproductive system, or an acquired malady. In the event that fertility cannot be achieved or restored through pharmacologic or surgical intervention, conception is not necessarily out of reach.
Sperm Retrieval
In the event of a failed vasectomy, uncorrectable ejaculatory obstruction, or low sperm count, motile sperm may be retrieved directly from the testes using a number of minimally invasive procedures. Extracted sperm is then paired with an egg in hopes of achieving fertilization through such methods as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The following forms of sperm retrieval are routinely utilized by the fertility specialists of Academic Urology and Urogynecology of Arizona:
- MESA (Microscopic Epididymal Sperm Aspiration): During this procedure, an incision is made in the scrotal sac. Using a microscope, the doctors of Academic Urology and Urogynecology of Arizona locate the Epididymal tubules and aspirate sperm-rich fluid. Retrieved sperm can be used immediately for intracytoplasmic injection, or can be frozen for subsequent IVF-ICSI efforts.
- PESA (Percutaneous Epididymal Sperm Aspiration): During PESA, a needle is passed through the scrotal skin, into the epididymis. Sperm is then aspirated. Using this procedure, sperm yields are typically small and therefore are sufficient for just a single IVF-ICSI effort.
- TESE (Testicular Sperm Extraction): TESE requires an incisions in the scrotal skin through which a small piece of testicular tissue is removed. Sperm is later extracted from this tissue by an embryologist. Tissue can be frozen to be used for later fertilization efforts.
- TESA (Testicular Sperm Aspiration): Using this form of sperm retrieval, doctors excise testicular tissue not through an incision, but via a syringe. Sperm yields are typically adequate for a single IVF-ICSI cycle, but not enough for subsequent use. TESA is often used as a precursor to TESE to pinpoint an area of adequate sperm production.
- Testis Micro Dissection: Reserved for patients with very low levels of sperm production, a testis micro dissection involves a scrotal sac incision in which the testis is dissected until an area of adequate sperm production is found. This tissue is then removed and the sperm excised.
For men faced with challenging fertility obstacles, Assisted Reproduction Techniques provide a hope for conception. Speak to the specialists of Academic Urology and Urogynecology of Arizona for additional information. As leaders in the field of urologic medicine, we specialize in executing proven and evidence-based practices that are molded around the unique needs of each patient.
