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Microsurgical Testicular Sperm Extraction
Microsurgical testicular sperm extraction (microTESE) is a specialized surgical procedure used to retrieve sperm directly from the testicles of men who have little or no sperm in their ejaculate due to conditions such as non-obstructive azoospermia. This procedure is often performed as part of assisted reproductive technology (ART) treatments to enable these men to father biological children.
Process of Microsurgical Testicular Sperm Extraction:
- Evaluation: Prior to microTESE, a comprehensive evaluation of the male reproductive system is conducted, including hormone testing and imaging studies to assess the structure and function of the testicles.
- Microsurgical Procedure: MicroTESE is performed under high-powered magnification (microscope), allowing the surgeon to identify and extract tiny sperm-containing tubules from within the testicular tissue with minimal damage to surrounding structures.
- Sperm Retrieval: The retrieved tubules are carefully dissected, and any viable sperm found within them are collected for further processing and use in ART procedures such as intracytoplasmic sperm injection (ICSI).
- Cryopreservation: In cases where sufficient sperm are retrieved, they may be cryopreserved (frozen) for future use in multiple ART cycles, reducing the need for repeat surgical procedures.
Indications for Microsurgical Testicular Sperm Extraction:
- Non-Obstructive Azoospermia: Men diagnosed with non-obstructive azoospermia, where sperm production is impaired within the testicles due to factors such as genetic abnormalities, hormonal imbalances, or prior medical treatments.
- Previous Sperm Retrieval Failures: Men who have previously undergone unsuccessful sperm retrieval procedures, such as conventional TESE or percutaneous biopsy.
- Fertility Preservation: Men facing treatments (e.g., chemotherapy) that may compromise sperm production can undergo microTESE to preserve their fertility before undergoing therapy.
Considerations:
- Success Rates: The success of microsurgical testicular sperm extraction depends on various factors, including the underlying cause of azoospermia, the expertise of the surgical team, and the quality of retrieved sperm.
- Post-Procedure Recovery: Patients typically experience mild discomfort and swelling following microTESE, which resolves within a few days to weeks.
- Ethical Considerations: Microsurgical testicular sperm extraction raises ethical considerations regarding the use of sperm in ART procedures, consent for sperm retrieval, and potential implications for offspring.
Microsurgical testicular sperm extraction offers hope to men with severe sperm production issues, providing a pathway to biological fatherhood through advanced reproductive techniques.
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