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TESE and MESA
Hope for Men Battling Infertility
By C.J. Johnson
Gird up your loins men! The battle against infertility is taking on new ferocity. Even for men who have severe infertility, there is hope. Testicular sperm extraction better known as TESE and microsurgical epididymal sperm aspiration (MESA) are two effective ways to retrieve viable sperm from men with sperm duct blockage or the absence of sperm in the semen.
With TESE, local anesthesia is administered before a thin needle is inserted into the testicle(s). Miniscule specimens of the testicular tissue are removed with a Tru-cut biopsy. The tissue is then teased apart with fine forceps to release the sperm. This tissue can then be inspected under a microscope to evaluate the number and quality of the sperm. If more tissue is required, it can be obtained from the same testicular site or other sites through the same incision. This approach provides the advantage of obtaining significant amounts of tissue.
MESA is a procedure wherein the epididymis is isolated through a 1/2-inch incision made in the scrotal skin. A directed biopsy of the epididymal tissue is made with microsurgical equipment. An operating microscope examines the tubules of the epididymis that contain the sperm. The fluid within a dilated tubule is collected and examined for the presence of sperm. If the fluid has no sperm or only dead sperm are found, another area of the epididymis is sampled. This is done until enough sperm are obtained to use and to store for future use. The collected sperm are then taken to the in-vitro fertilization (IVF) lab for processing and freezing.
Of the two procedures, MESA is considered the most effective for the following reasons:
- It recovers the highest quantity of sperm.
- It retrieves the best quality of sperm.
- It is the safest procedure with the fewest complications.
- It is a one-time procedure.
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