MESA/TESE

To treat men with azoospermia—no sperm—the underlying cause of this condition must be established.

Obstructive problems due to vasectomy, congenital absence of the vas deferens, or scarring of the vas deferens can be treated by microepididymal sperm aspiration (MESA), a technique in which an urologist obtains sperm from part of the male reproductive tract, such as the epididymis, the vas deferens, or the testicle. The collected sperm are then frozen until the eggs are ready to be fertilized.

If the cause of azoospermia is testicular failure rather than obstruction, testicular excisional sperm extraction (TESE) is performed.

For this method, a small portion of testicle tissue is removed and explored for immature sperm. The recovered sperm can then be used in ICSI.

The TESE procedure is done on the day of the egg retrieval, because cryopreservation of TESE obtained sperm decreases the chances of success.