In women, the absence of pregnancy despite having unprotected sexual intercourse during at least 12 ovulation periods is called infertility. Infertility can be of female or male origin.
Although sperm quality appears to be an important factor when it comes to male-induced infertility, it is also possible to find no sperm cells in the semen of some men as a result of sperm analysis. The absence of any viable or inanimate sperm cells in the semen after at least two sperm analyzes performed at different time periods is called azoospermia.
Azoospermia is classified as obstructive or non-obstructive. In the case of azoospermia due to obstruction, sperm are produced in the testes, but there is a problem in the process of merging sperm with other fluids that make up semen, or in the process of being excreted out of the body along with the semen. In azoospermia, which is not due to obstruction, sperm production does not occur in the testicles.
Azoospermia treatment, which is one of the common causes of male-induced infertility, can be planned in accordance with the diagnosed type of azoospermia. However, in case of IVF treatment, it is possible to obtain sperm from men using different sperm harvesting techniques. Embryo(s) can be created by bringing together the sperm and egg cells harvested and healthy pregnancies can be achieved. As a matter of fact, sperm collection techniques are among the most important requirements for in vitro fertilization and instracytoplasmic sperm injection (ICSI).1
It is a technique performed for the purpose of harvesting sperm from the epididymis. It is applied to azoospermia patients with vas deferens and epididymis blockages or congenital canal deficiency. During the operation performed via microsurgical technique, a lot of sperm cells can be harvested.
It is a method performed under local anesthesia in order to collect sperm-containing fluids from the epididymis. Although it provides fewer sperm cells compared to MESA, it can offer sufficient efficiency for ICSI. The decision must be made depending on the patient's condition.
It is performed for the purpose of harvesting sperm from the testicular tissue. It is possible to be performed it in the clinic or operating room under local anesthesia. It is carried out in coordination with egg retrieval during the IVF/ICSI process. It is performed to patients with azoospermia, which is due to obstruction. If PESA and MESA are not used, TESA is typically the method that is resorted to.2
It is the most advanced surgical method performed to find sperm cells in non-obstructive azoospermia patients. It is possible to examine all the parts of the testicles that are likely to contain sperm cells in great detail and to take tissue from the parts that are likely to contain it. While the operation is in progress, the tissue samples collected are sent to the embryology laboratory.3
Sperma cells are not always found as a result of microTESE surgery. The success rate of the operation is 50% -60%. If sperm cells are found, these are mechanically inserted into the egg cells. In other words, embryo formation is targeted with the ICSI method.
1 https://www.urologyhealth.org/urology-a-z/s/sperm-retrieval
2 https://emedicine.medscape.com/article/2036812-overview#a3
3 https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/sperm-retrieval-procedures
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