In the cases where no sperm cells exist in the semen or where no motile sperm cells can be found, sperm cells can be acquired by using the TESA-TESE procedure, and these sperms can be used to achieve conception by micro-injection.
Usually local anesthesia is used on the testes for this procedure, but if the patient requests it, general anesthesia can also be performed. Using a fine needle and a syringe, the testicular tissue is sucked out. The testicular tissue is placed in culture media and sent to the lab, where it is examined under the microscope for sperm cells. This procedure is called TESA (Testicular Sperm Aspiration).
Usually local anesthesia is used on the testes for this procedure, but if the patient requests it, general anesthesia can also be performed.Testicular sperm extraction (TESE) is the process of removing a small portion of tissue from the testicle and confirming the presence of few viable sperm cells under the microscope. In the 2-3 days following this procedure, it is recommended that the patient minimizes the time standing up.
In our clinic, our patients first receive the TESA procedure, and TESE remains as a secondary option if the first procedure is not successful. In both of the procedures, the sperm cells that were harvested can be immediately used, as well as being frozen to be used at a later time, in order to avoid the hardship of a second procedure.
Percutaneous epididymal sperm aspiration (PESA) is the procedure of harvesting sperm cells with a fine needle from the epididymal tubules on the testes, without even having to make a skin incision.
If there is suspicion of a blockage in the reproductive tracts (such as the absence of vas deferens from birth), MESA (micro-epididymal sperm aspiration) is the best way to extract sperm cells. However, since this procedure involves microsurgery where the scrotum is opened and has low chance of being repeated, MESA should be used only on very suitable patients.
This is the TESE procedure done with the aid of a microscope. Here the aim is to find with precision tubules with a big potential for sperm cells without taking out big tissue portions from the testes.