Both TESA (Testicular Sperm Aspiration) and TESE (Testicular Sperm Extraction) are medical procedures of sperm extraction, performed in case of male infertility. This may be caused by the condition called Azoospermia, which means that sperm is absent in the semen. These procedures are common for infertility treatment in many Ukrainian reproductive medical centers. With such procedures as TESE and TESA IVF is required in order to achieve pregnancy.
Conditions requiring TESA and TESE
Azoospermia is diagnosed among 5-10% of men with infertility. Men can be born with it, or obtain it later in life. It is a condition, which can be caused by obstructive or non-obstructive process. It is important to find the cause of Azoospermia before starting the infertility treatment. Both processes require different medical procedures. Men with non-obstructive Azoospermia in most cases have some type of genetic condition, which causes the lack of sperm.
- Obstructive Azoospermia the sperm produces normally, but the reproductive tract is blocked. Because of this the amount of sperm that gets into semen is insufficient. Obstructions are most likely to be diagnosed in ejaculatory duct, epididymis or vas deferens. It can be caused scrotal injury or trauma, different infections, genetic conditions, etc.;
- Non-obstructive Azoospermia this means poor sperm production. The amount produced is insufficient in the beginning, even though nothing is blocking the tract. This type is more difficult to treat. There are many factors which can potentially cause this Azoospermia: genetic conditions, certain medications, exposure to toxins and radiations, excessive smoking and alcohol intake, etc.
TESA and TESE
In case of lack of the sperm in the semen, spermatozoa are obtained surgically. Two of the most popular and effective procedures are TESA and TESE:
- TESA this procedure is a part of IVF and local anesthesia is required. Tissue and sperm are aspirated through inserting a needle in the testicle. This procedure is suitable for patients suffering from obstructive Azoospermia;
- TESE this involves testicular biopsy. Tissue can be taken from several different areas of the testicle. Sperm is extracted from the retrieved tissue and is used for egg fertilization or cryopreservation for the future IVF. This is performed either with sedation or local anesthesia.