TESTICULAR AND EPIDIDYMAL ASPIRATION
Azoospermia (absence of SPZ in the ejaculate) is treated through the following processes:
Step 1: Epididymal or testicular extraction.
Sample processing:
The surgery room at the Punta Pacifica Reproductive Center is certified by the Technical Board of Health as a Center for Outpatient Surgery. Our facility fully equipped to perform the following procedures.
Obtaining sperm from testicular tissue. PESA, TESA, TESE procedures take place in our surgery room where the patient is subjected to local or general anesthesia, as needed.
The micro-surgical aspiration of sperm from the epididymis (MESA) in combination with ICSI has helped improve fertilization rates, which are almost similar to those obtained from ICSI with ejaculated sperm.
The cryopreservation of sperm that has been obtained from the testis and epididymis allows for sperm surplus to be frozen in order to avoid going through the process once more if other treatment is needed. The Percutaneous Epididymal Sperm Aspiration (PESA) technique is less invasive, has a lower cost and requires almost no training in microsurgery techniques. Although the quality of the samples is lower than that obtained in MESA, they can still be cryopreserved and used in subsequent cycles of ICSI.
There are cases which the only source of spermatozoa is in the testis, and in these circumstances, there is the possibility of fertilization and pregnancy by microinjecting sperm from a biopsy of the testicle. cryopreservation prevents the recurrence of testicular aspirations, which has its advantages, due to the fact that there has been evidence of inflammation and bruising in the testicle up to six months after the procedure; it is also important because it is not possible to predict the results of an aspiration, thus ensuring the availability of sperm before starting the female’s ovarian stimulation.
Step 2: Donor sperm is used if no sperm is recovered or if despite performing ICSI, no fertilization occurs.