Sperm harvesting is a surgical procedure used to find and retrieve sperm from the testicles of men who do not have sperm in their ejaculate (azoospermia). The process of finding and retrieving sperm can help improve infertility outcomes in males who have issues with azoospermia or azoospermic couples attempting IVF. There are several different procedures used to harvest sperm from the testicles including PESA, MESA, and TESA or microTESE. The method chosen will depend on the underlying cause of the azoospermia which should be assessed and carefully evaluated first.
Using either MESA or TESA a wide-bore needle is pushed percutaneously into the testis to obtain a sample of sperm from the seminiferous tubules and surrounding tissue. These sperm are then screened under a microscope for motile and immotile spermatozoa. These sperm are then used for ICSI.
MESA and TESA are the most commonly used sperm extraction methods. MESA is also known as micro-epididymal sperm aspiration. During MESA, sperm are removed from the epididymus to enhance sperm collection. During a MESA procedure, a wide-bore catheter is connected with extension tubing to a syringe to allow suction to be applied. A needle is then passed into the testicle and a vacuum is created in order to extract sperm.
MESA has been shown to have a higher success rate than TESE in patients with azoospermia. In addition, fresh MESA cycles have been shown to dramatically improve cleavage, blastulation and implantation rates in patients with azoospermia after prior IVF-TESA-ICSI cycles had poor cleavage and implantation rates. tesa mesa
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