There may be some reasons couples aspiring to have a child are unable to conceive a baby. To find out your options to father a child, consult with your fertility specialists. Here's a look at some of the surgical techniques for sperm retrieval.
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| Male Sperm |
All You Need to Know about Surgical Sperm Retrieval
Azoospermia, a condition in which the semen is absent of sperm or significantly less sperm, causes infertility in men. This can be due to blockages or injuries.
Couples aspiring to have a child often find themselves challenged by their body. There may be reasons they are unable to conceive a child. Often a consultation with your physician will lead you to a fertility specialist.
Men sometimes suffer from azoospermia, in which the semen lacks sperm or has less sperm. This can happen due to blockages or injury.
When a male is suffering from infertility, the doctors assist the couple by helping them retrieve the sperm surgically and carrying out the procedure of IVF.
What are the Causes of Male Infertility?
To impregnate a woman, the male has to produce healthy sperm, get an erection and ejaculate the sperm into the vagina. If any of these is not being met, the female cannot get pregnant.
Sperm disorder:
Being unable to produce healthy sperm is the root cause of male infertility. The sperms are immature or abnormal in shape and therefore unable to swim through the vaginal cavity to meet the egg. Sometimes, the sperm count is less.
It could be because of any of the following factors:
- Infections or inflammatory diseases
- Immunity disorder
- Lifestyle influences like tobacco and alcohol consumption
- Hereditary diseases like fibrosis
- Hormonal or pituitary gland malfunction
Structural defect:
The genital tract could be blocked due to several reasons, such as
- Infection or inflammation due to sexually transmitted disease
- Congenital birth defect
- Fibrosis due to injury or surgery.
- Twisted or swollen veins in the scrotum.
The doctor says that it is possible to restore the flow of the semen by surgical intervention in case a person is suffering from twisted swollen veins.
How is sperm retrieval carried out?
Your ART (assisted reproductive technology) specialist will carry out the sperm retrieval procedure in any of the following ways based on:
- Whether it is possible to get the sperms through the skin or open surgery is required.
- How much tissue is needed, and how it will be retrieved (biopsy or aspiration)
- From which location the tissue will be retrieved (testicle, epididymis, or vas deferens)
- What instruments are used (microsurgical or conventional)
How does the doctor know which procedure is to be used?
There are 2 ways of concluding as to which method should be for aspiration.
- Testicular biopsy
- FNA mapping.
Although testicular biopsy is less helpful in finding out where and how the sperm should be aspirated, it is more beneficial in diagnosing testicular cancer.
On the other hand, FNA mapping (fine needle aspiration) can give an accurate diagnosis and is most helpful in determining the method of sperm retrieval.
The image below shows 12 FNA mapping sites per testis.
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| 12 FNA mapping sites per testis |
Surgical Procedures of Sperm Retrieval:
The surgeon or the ART specialist at IVF centre will either use a percutaneous retrieval method or open microsurgery for the process of sperm retrieval. Though expensive, open microsurgical techniques have a higher chance of sperm retrieval than the percutaneous aspiration method.
TESE AND MESA fall under the open microsurgery method, whereas TESA AND PESA fall under the percutaneous aspiration method.
TESE:
Testicular Sperm Extraction is a technique where the testicular biopsy tissue is used for sperm extraction. If the sperm is not found in that tissue, another tissue biopsy is carried out to locate a sperm. Although it is time-consuming and slightly invasive, the chances of sperm retrieval are higher since the tissue sample is significant.
TESA:
Testicular Sperm Aspiration is a technique in which a microneedle is inserted to extract tissue. If the sperm is present in the tissue, it is used. Otherwise, the needle is inserted at a different location to get a sample. Although this is a faster technique, it may need quite a few repetitions to locate a sperm.
MESA:
Micro Epididymal Sperm Aspiration is a technique where the epididymis (the tube carrying the sperm after it leaves the testis) is exposed under the surgical microscope, and fluid is collected from a dilated epididymal tubule using a catheter. Once the fluid is collected, the tubule is either cauterized or sutured back.
PESA:
Percutaneous epididymal sperm aspiration is a technique where the surgeon inserts a 23-gauge butterfly needle into the caput dilated epididymis and aspirates the fluid while moving the needle back and forth. The epididymis is held between the forefinger and the thumb for a better approach while the scrotum skin is overstretched.
Following this procedure, the IVF specialist carries out the procedure of artificial insemination.
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| Surgical Sperm Retrieval Procedures |
Conclusion:
With the advancement of surgical procedures, the specialists have kept themselves appraised and undergo continuous training in newer technologies.
Assisted reproductive technology (ART) procedural success rates have increased at their centre. Although the urologist and fertility specialists will give in their hundred percent to help you with a baby of your own, there are times you need to be mentally prepared for using donor sperm to carry out an IVF.
If you are looking to carry out these procedures in a cost-effective country, going through healthcare provider portals is a much safer and faster option.
Read Also: Let’s Normalize Talking About Infertility: Your Guide to Fertility