There are several techniques for obtaining sperm. From these techniques, pregnancy became possible for men with no sperm in the ejaculate. A combination of the intracytoplasmic sperm injection technique (ICSI) is performed with one of the sperm recovery techniques.
Azoospermia is defined as the absence of sperm in the seminal fluid after centrifugation of all ejaculated material.
AZOO = absence
SPERMIA = sperm
- There is sperm production in the testicles, but the sperm cannot reach the ejaculate. In this case, the problem would be the conduction / transport of sperm.
- Performs the collection of Epididymal sperm.
- Vasectomized Men
- Men with bilateral deferens agenesis
PESA (Percutaneous aspiration of epididymal sperm): The sperm from the epididymis (gland located inside the scrotum just above and glued to the testis) are obtained mainly by percutaneous aspiration of epididymal sperm (PESA) with a fine needle, preceded by local anesthesia.
MESA (Microsurgical aspiration of epididymal sperm): The principle of MESA is the same as that of PESA), that is, aspirate epididymal fluid. However, unlike PESA, where the approach is percutaneous, at MESA the approach is open and microsurgery is employed.
Non-obstructive azoospermia: Testis produces little or no sperm.
In this case, obtain testicular sperm
- Men with non-obstructive azoospermia
- Men with obstructive azoospermia but with
- Failure in the acquisition of spermatozoa by PESA / MESA
Testicular sperm can be obtained in two ways: a biopsy (TESE – Testicular sperm extraction) or fine needle aspiration (TESA – Testicular sperm aspiration), both preceded by local anesthesia.
There are cases of azoospermia in which the surgical removal of sperm from the testicles is performed by microsurgery – the testicle is scanned under a microscopic view to find the sperm – a technique called Micro TESE, which means microdissection of testicular sperm. This is a longer procedure and requires block anesthesia as it may take time to find sperm.
However, the evaluation by a specialist doctor to define the type of azoospermia and more laboratory results, such as the semen processing spermogram, are essential for choosing the technique to be performed.