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| MicroTESE
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Micro
TESE is
a method for treating malefactor
infertility that allows couples
who might otherwise remain childless
to achieve pregnancy.
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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.
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.
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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.
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You may shower after 24 hours. Do
not take a bath or use a hot tub
for five (5) days.
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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.
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You
may continue your normal diet.
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You
may return to work after 48 hours,
as long as your job is sedentary
and does not involve heavy lifting.
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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.
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