Testicular failure affects approximately 1% of the entire male population and over 10% of men who seek fertility evaluation. At Dogus IVF Centre we understand the problems that male infertility can cause, both physically and emotionally. Until recently, it was assumed that men with infertility problems were untreatable. However, with today’s technology, cyprus IVF Centre are able to use surgical procedures to increase the chance of fertilisation.
PESA – TESE – MESA
PESA, TESE or MESA are used to assist couples where the male partner has no sperm present in the seminal fluid when he ejaculates. All of the procedures are used along with ICSI to guarantee fertilisation.
The medical term for the absence of sperm is Azoospermia. There are two types of Azoospermia:
1. Obstructive Azoospermia – sperm are created, but cannot be mixed with the rest of the ejaculatory fluid due to a physical obstruction
2. Non-obstructive Azoospermia – there is a problem with spermatogenesis, as in the condition of hyperprolactinemia. There are a number of reasons why some semen samples may have no sperm present:
• There may be a blockage of the tubules that carry the sperm from the testicles to the penis.
• The passages themselves may not have developed during puberty and so sperm cannot be transported.
• Sperm may be produced but in low numbers, and therefore not seen in the semen sample.
• The male may have had a vasectomy performed which means that the passages that carry the sperm have been severed.
Percutaneous Epididymal Sperm Aspiration (PESA)
The PESA procedure is either performed under general anaesthetic or local anaesthetic with sedation. At Cyprus IVF Centre, we prefer to use local anaesthetic with sedation as there are less complications and a faster recovery rate. During the procedure, a fine needle is inserted into the epididymis (a narrow, tightly-coiled tube connecting the efferent ducts from the rear of each testicle to its vas deferens) to extract fluid. The fluid is then analysed in the cyprus ivf laboratory by our embryologists who select the sperm to be used with ICSI.
Testicular Sperm Extraction (TESE)
TESE is the most common of the three procedures and is usually used for men who have had a vasectomy or failed vasectomy reversal. We use local anaesthetic for the TESE procedure. A small sample of testicular tissue is extracted from the testes with a fine needle being inserted into the testes. It is a straightforward procedure taking approximately 15 minutes to complete. Again, the embryologists will analyse the tissue in the laboratory and select sperm to use for ICSI fertilisation. Our cyprus nurses will administer a pain killer via injection into the gluteus muscle if there is any discomfort after the procedure.
Micro-epididymal Sperm Aspiration (MESA)
MESA is a procedure to retrieve sperm from the epididymis in men who have a diagnosed blocked vas deferens and it is usually carried out under general anaesthetic. Men who require MESA normally have low quality sperm and so Dr Firdevs will proceed to ICSI immediately to promote the highest possible chances of fertilisation.
Intracytoplasmic Sperm Injection (ICSI)
As mentioned previously, sperm that is extracted by the above procedures will then be used in conjunction with an ICSI cycle.
ICSI is the process whereby a single sperm is injected directly into a mature egg. Our expert Cyprus embryologists are skilled in selecting the best sperm from the samples obtained during PESA, TESE or MESA. After fertilisation, the eggs will be placed in a temperature regulated incubator and monitored over the course of the following day. Embryo Transfer is normally scheduled for 2 or 3 days following egg collection.
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