Micro TESA (Microdissection Testicular Sperm Extraction)
Micro TESA, also known as microTESE, is an advanced microsurgical procedure used to retrieve sperm directly from the testicular tissue in men with non-obstructive azoospermia (NOA). It is considered the gold standard when conventional sperm retrieval methods fail.
What is Micro TESA?
Micro TESA is a precise surgical technique that involves using an operating microscope to identify and extract seminiferous tubules that are most likely to contain sperm. This increases the success rate while minimizing damage to surrounding tissue.
Purpose of Micro TESA
- To retrieve sperm for IVF/ICSI in men with non-obstructive azoospermia.
- To maximize sperm retrieval while minimizing testicular damage.
- To offer a chance of biological fatherhood to men with severely impaired sperm production.
Step-by-Step Process
- Consultation & Evaluation: Includes hormonal tests, genetic analysis, scrotal ultrasound, and counseling.
- Preparation & Anesthesia: The procedure is typically done under general or regional anesthesia.
- Microsurgical Dissection: A small incision is made in the testis. Using a high-powered microscope, the surgeon identifies tubules more likely to contain sperm.
- Tissue Extraction & Sperm Isolation: Selected tubules are removed and processed in the lab to isolate viable sperm.
- Recovery: Patients may experience mild discomfort. Recovery is usually quick with supportive care and medications.
Ideal Candidates
- Men diagnosed with non-obstructive azoospermia.
- Patients who previously failed other sperm retrieval techniques.
- Men seeking fertility preservation before treatments like chemotherapy.
Success Rate
- Micro TESA offers a higher sperm retrieval rate than conventional TESE.
- More successful in detecting and preserving sperm in challenging cases.
- Better outcomes due to minimal tissue damage and improved visualization.
Advantages
- Higher success rates in sperm retrieval.
- Minimally invasive with better preservation of testicular tissue.
- Outpatient procedure with relatively quick recovery.
- Can be combined with sperm freezing for future use.
Fructose Testing in Male Infertility
Fructose testing is a semen analysis parameter used to evaluate the presence of fructose, a sugar secreted by the seminal vesicles. It plays a critical role in nourishing sperm and is used to assess seminal vesicle function and potential blockages.
What is Fructose Testing?
Fructose provides energy for sperm motility and is essential for male fertility. This test is especially relevant in evaluating men with azoospermia (no sperm in the semen).
Purpose of Fructose Testing
- To assess the function of the seminal vesicles.
- To help identify causes of azoospermia, especially obstructive types.
- To evaluate possible congenital abnormalities (e.g., absence of vas deferens).
- To differentiate between obstructive and non-obstructive azoospermia.
How is the Test Performed?
- Sample Collection: The semen sample is collected after 2–5 days of sexual abstinence.
- Laboratory Analysis: The sample is analyzed to detect the presence or absence of fructose.
- Interpretation: Absence or very low fructose levels may indicate obstruction or seminal vesicle dysfunction.
Ideal Candidates
- Men with azoospermia or very low sperm count.
- Men with a history of surgeries or infections affecting the reproductive tract.
- Individuals undergoing a complete infertility workup.
Clinical Significance
- Helps in planning further diagnostic procedures like TESA or Micro TESA.
- Can guide treatment decisions in IVF/ICSI cycles.
- Important for evaluating potential anatomical issues.
Advantages
- Non-invasive and simple test.
- Useful in detecting obstructive vs. non-obstructive causes.
- Valuable diagnostic tool as part of the infertility assessment.