TESA

TESA in Ghatkopar, Mumbai

TESE –Testicular Sperm Extraction

INTRODUCTION: WITH the surgical sperm retrieval techniques now sperms from the epididymis or testes are used to help the azoospermia men become biological fathers.

Indications

• Obstructive azoospermia
• Non obstructive azoospermia
• Failure to ejaculate prior to an icsi procedure
• Failure of vibrator stimulation
• Total astheno/ necrozoospermia

Procedure

A fine needle is inserted into the testis and samples of tissue are obtained by gentle suction in order to retrieve enough sperms.
Gentle suction is applied using a 10 ml or 20 ml syringe

The needle is rotated 180 degrees ,out and in motion of the needle is repeated a few times till aspirate is seen in the tubing of the needle. The needle is withdrawn slowly out of the testes.

The fluid and the tissue obtained are checked for sperm under microscope.

PESA – Percutaneous Epididymal Sperm Aspiration – A fine needle is inserted into the epididymis, at the upper area of the testis and sperms are obtained by gentle suction.

Procedure

The epididymis is located and palpated then it is stabilized between thumb and forefinger. Then it is punctured directly through scrotal skin with a 26-g needle attached to a tuberculin syringe containing 0.1 ml of sperm-washing medium.The syringe is rotated around 180 degrees and the contents of the syringe are emptied onto a dish and examined for the presence of sperms under microscope.

Microsurgical Epididymal sperm Aspiration (MESA)

Procedure

Under an operating microscope scrotal incision is made. Then an epididymal ductule is gently mobilized and opened. The spermatic fluid is then aspirated. Microsutures are used to close the ductule.