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MicroTESE :

Micro TESE is a method for treating malefactor infertility that allows couples who might otherwise remain childless to achieve pregnancy.

MicroTESE

Microsurgical Testicular Sperm Extraction is a method for treating malefactor infertility that allows couples who might otherwise remain childless to achieve pregnancy. MicroTESE is a microsurgical method for obtaining sperm from a male who does not have sperm in his ejaculate (azoospermia), particularly in males who do not have a blockage in their reproductive tract (non-obstructive azoospermia).
Many of these patients were previously considered to have no options for assisted reproduction. Because an operating microscope is use for the procedure, microTESE allows the identification of sperm-containing regions of the testicle, in individual seminiferous tubules, and the removal of sperm directly from these regions.

Since the sperm that are obtained from the microTESE procedure freeze very poorly, the procedure needs to be done the day prior to egg retrieval from the partner, so the partner must be under the care of a female fertility specialist. It is also possible that sperm may not be found during microTESE.
This is a method for treating male-factor infertility that allows couples who might otherwise remain childless to achieve pregnancy. MicroTESE is a microsurgical method for obtaining sperm from a male who does not have sperm in his ejaculate (azoospermia), particularly in males who do not have a blockage in their reproductive tract (non-obstructive azoospermia). Male patients have undergone genetic testing as part of the evaluation for this procedure.

Many of these patients were previously considered to have no options for assisted reproduction. Because an operating microscope is use for the procedure, micro-TESE allows the identification of sperm-containing regions of the testicle, in individual seminiferous tubules, and the removal of sperm directly from these regions. With the development of the microTESE procedure, couples with this specific type of male-factor infertility can be offered this option and often successfully helped in their goal of establishing a pregnancy.

There are no prognostic factors that predict the ability to successfully locate sperm during the microTESE procedure, but typically the number of sperm is quite small. Due to the low number of sperm obtained by this method, the sperm must be combined with the partner’s eggs using intracytoplasmic sperm injection (ICSI), the most sophisticated form of assisted reproduction. The ICSI procedure involves the injection of a single sperm into an egg using microscopic instruments in order to fertilize the egg.

Since the sperm that are obtained from the microTESE procedure freeze very poorly, the procedure needs to be done the day prior to egg retrieval from the partner, so the partner must be under the care of a female fertility specialist. It is also possible that sperm may not be found during microTESE. The couple may wish to consider having donor sperm available so that in vitro fertilization may continue, as the female partner would be ready to continue the IVF process. Alternatively, if no sperm is found, the egg retrevial may be cancelled.

Surgery

MicroTESE is an outpatient surgery, and can be done either under a general anesthesia or local anesthesia. You will arrive 1-2 hours before the surgery and check in at the outpatient surgery unit. The actual procedure takes approximately 1 to 4 hours, depending on the complexity of the case. After the surgery, there is a brief recovery period if a local anesthetic has been used, and a 1-2 hour recovery period after a general anesthetic. You must bring a driver with you to this surgery- you will not be allowed to drive yourself home, regardless of the type of anesthesia.

Recovery
  • Keep physical activity after the surgery to a minimum, until you have been cleared by Dr. Ohl. This includes avoiding any heavy lifting, exercise and sexual activity.
  • You may shower after 24 hours. Do not take a bath or use a hot tub for five (5) days.
  • Expect some mild pain, mild swelling of the scrotum and possible slight fluid leak from the incision site(s). A gauze pad may be applied to the incision if there is any leakage.
  • You may continue your normal diet.
  • You may return to work after 48 hours, as long as your job is sedentary and does not involve heavy lifting.
  • Prescription pain medication will be provided. You may also take Extra-Strength Tylenol, Motrin or Advil as needed for any pain or discomfort after the first two to three (2-3) days.

Follow-up

A regular postoperative appointment will be scheduled approximately 10-14 days after the surgery to make sure healing is progressing properly.

 

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