What is the need to remove sperm surgically?
Sperm retrieval is possible when the couple wants to get pregnant but it is not possible naturally. Around 10 to 15 percent of men are diagnosed with infertility at the IVF centre and they have no sperm when they ejaculate. This problem is referred to as azoospermia.
Around 40% of the cases are due to obstruction in the reproductive tract. This can happen due to:
- You had a Vasectomy
- You have STD like Chlamydia.
- Men who have undergone radiotherapy or chemotherapy.
- Genetic condition that affects fertility level.
- Undergone surgery to bring down undescended testes.
- Removed the testicles.
For increased conception chances, along with IVF, the ICSI treatment is recommended. The fertility doctor will do a semen analysis to check for the sperm in the semen. There are 2 types of azoospermia (no sperm in the semen):
- Obstructive azoospermia
The sperm production is normal but the reproductive tract on both sides of the testicles is blocked. It means the sperm cannot get into the semen. In some cases, the male has a problem on each side of the scrotum.
- Nonobstructive azoospermia
In this case, sperm production is poor. The semen does not have enough not of sperm. This condition is a challenge to treat but with the advancement of technology, it has made it possible to restore the sperm presence in the semen. It is caused by certain medications, health conditions, tumors, radiation therapy, anorchia (absence of testicles), and surgery.
What are the recommended treatment options?
- TESE
In this incision is made into the testicle to take a small sample so that the sperm can be recovered from it. The treatment is performed under general or local anesthesia. If multiple samples need to be taken from different areas then the procedure is known as Multi-site TESE and the person is given general anesthesia.
- PESA and TESA
With both methods, the fine syringe is used which is inserted into the testicle or epididymis to retrieve the sperm. The procedure is painless and quick so it is performed under local anesthesia.
- MESA and MicroTESE
Both these procedures are performed by giving patients general anesthesia. In MESA, the epididymis is examined under the microscope and fluid samples are taken to check if there is any presence of the sperm.
In MicroTese, the testicles are examined with the microscope to examine the areas where sperm is made. The areas are taken to extract the sperm. This method is best for patients with nonobstructive azoospermia. Following the procedure, you need to rest for a few days and medications are prescribed by the doctor.
Possible side effects
Side effects are rare but infection and bleeding can occur. In some cases, the testosterone level drops which creates problems like muscle weakness, difficulty sleeping, anxiety, and affect sexual performance.