What are PESA, MESA, TESA, TESE -the various procedures of sperm retrieval?

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The infertility figures are climbing up and the modern couples are facing problems in conceiving far greater than their older counterparts. While the male partners may account for 20 % of the cases, the female usually carries the reasons for a larger percentage of unsuccessful conception. While females may attribute their infertility to a wide range of factors such as PCOD, endometriosis,pelvic inflammation etc., the males usually have poor sperm motility to blame.

Poor sperm quality or complete absence of sperms in the semen is also a causative factor. Such males are unable to help the female partner reproduce successfully. The reasons for this may vary but in many cases, the sperms themselves are absent in the semen that is ejaculated. The condition which is marked by the absence of sperm in the semen is called Azoospermia.

The roots of the problem may lie in the procedure of sperm production. But the fault could also lie in the fact that the flow of the semen may be obstructed. The reason of obstruction may be due to some injury or as a result of some trauma or infection. The injury might be in the genital area itself but could also occur during surgery of the scrotum.

Some congenital conditions also cause the problem. Such conditions are usually uncommon in men, but nearly 2 percent of the male population suffers from it. The total absence of vas deferens, popularly known as (CBAVD) or congenital bilateral absence of vas deferens is a major cause of azoospermia. It is known to occur in men with cystic fibrosis.

The occurrence of Azoospermia doesn’t mean that the man will not be able to reproduce. There are various techniques available for helping such males. The the procedure of sperm extraction offers help to such patients. Various sperm extraction techniques like  PESA, MESA, TESA, TESE are available at TESA Treatment Centre in India. According to the IVF center in India, the sperm so extracted can be used in IVF treatment.

Techniques for sperm extraction

  1. PESA (PESA or Percutaneous Epididymal Sperm Aspiration)

It involves the passage of a needle into the head of the epididymis through the scrotum. The fluid is aspirated after this step. The fluid is then handed over to the embryologist,  who retrieves the sperm cells from this fluid.

2. MESA (Microsurgical Epididymal Sperm Aspiration )

It involves the dissection of the epididymis and an incision on a tubule. As a result, the fluid spills out from tubules and starts pooling in the  Epididymal bed. The pooled fluid is aspirated from this site. This process may lead to an adverse effect on the sperm cells due to contamination by blood.

3. TESA and TESE

TESE is also known as testicular sperm extraction, which is technically the surgical biopsy of the testis. TESA, on the other hand, is the process of inserting a needle in the testis and performing the aspiration of fluid and tissue. The fluid is processed in the embryology laboratory. These sperms can be used in IVF or IUI, depending upon the circumstances.

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