The usual way of producing sperm for use in Assisted Reproductive Technology is manual stimulation. In cases where medical or religious factors prevent this, surgical methods can be used. Medical reasons that could contribute to inability to produce sperm though ejaculation could consist of azoospermia, low sperm count, low sperm motility. The following procedures help retrieve sperm through minor surgical procedures:
PESA (percutaneous epididymal sperm aspiration) is a method, performed under local anesthesia, which involves extracting sperm with a fine needle from the epididymis or testes. The sperm is then implanted into the egg through the process of ICSI (Intracytoplasmic Sperm Injection) to be used in IVF.
TESA & TESE
In cases where the epididymis does not contain any sperm, because of impaired sperm production, the method of TESA (Testicular Sperm Aspiration) or TESE (Testicular Sperm Extraction) may be used. TESE involves a surgical biopsy of the testis, while TESA is performed by sticking a needle into the testis and aspirating fluid and tissue with negative pressure.
The most invasive of the surgical sperm retrieval procedures is MESA (micro-epididymal sperm aspiration), which is performed under general anesthesia. MESA involves the cutting open of the scrotum to retrieve sperm. The wound is closed with dissolvable stitches. Swelling and pain subsides within a few days, during which prescribed painkillers may be taken to ease the pain.
These alternative methods of retrieving sperm allow male patients to use their own sperm in the IVF procedure. The procedures themselves are not very costly and offer the chance for couples to avoid the cost of using a sperm donor. At the Cyprus Fertility Clinic, we are committed to offering you low cost IVF treatment with high success rates. Some men do not produce sperm at all or only in insufficient numbers and poor quality. Many of these men can have their sperm aspirated directly from their testicles (TESA) or from the epididymis that stores the sperm prior to an ejaculation (PESA, MESA). The retrieved sperm are then used during in vitro fertilization, gestational surrogacy or egg donation treatments with Intracytoplasmic Sperm Injection (ICSI). The aspiration is a brief outpatient procedure requiring only mild sedation. Most sperm aspiration procedures are performed at our centre.
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