Male Infertility::

Testicular sperm aspiration (TESA) for diagnosis azoospermia & use in ICSI

The Centre specializes in the treatment of severe male infertility and assisted conception techniques such as ICSI permit the use of very few sperms or even spermatids (immature sperms) to achieve pregnancies. TeSA is the procedure of obtaining sperm from the testes using a fine needle.

Indications
 

The commonest cause of azoospermia (no sperm in the semen sample) is testicular failure. Rarely, this may be due to failure of the brain to stimulate the testes to produce sperm. This can be remedied with hormone injections and result in restoration of normal sperm production. Unfortunately, most cases seen have a primary fault in the testes and cannot be helped by the latter treatment. The only hope for these patients is TeSA. There are occasionally areas of the testes that contain small numbers of sperm that do not reach the tubes (vas) and seminal fluid.

What does TeSA involve?

Prior to the procedure the following blood tests are performed namely FSH, LH and Testosterone as well as the routine checks of Full blood count, Hepatitis B and HIV screens.

You should not eat or drink after 10 p m the night before your operation. Come to the centre at 0730 a m on the day of the procedure and you will be seen by the Anaesthetist (the doctor who will put you to sleep) and then by your consultant to sign the consent form.

What happens after the procedure?

You will be shown the sperm under a microscope before you leave the Centre. If no sperm are identified the tissue is re-examined the following morning so you can call the Centre to find out. If no sperm are found in the testicular tissue then we can get a special report from a laboratory to provide a definite reason for the Azoospermia. It will also show if there are any areas in the testes where mature sperm production is still occurring. This may provide hope as to the chance of success if the TeSA is repeated.

What if no sperm is obtained from TeSA?

The absence of sperm or spermatids from TeSA is confirmation of the total failure of sperm production. It means that we are not able to perform ICSI or any form of assisted conception. This can be a source of distress for both partners and your consultant will counsel you.

Will I experience any problems after the TeSA?

The procedure is normally very straightforward and you go home within an hour or two afterwards. Occasionally, there may be a bit of bruising and this can cause localized discomfort and discoloration around the scrotum. If you are very uncomfortable a scrotal support will be provided and you can take painkiller tablets. A couple of days after the TeSA you should be back to normal.

When can we have intercourse?

As soon as you feel up to it you can go ahead. Your libido and performance is not affected by the procedure. If you have testicular failure and low testosterone levels, you may be given a course of Testosterone injections (shots) by your consultant. Low testosterone level is a cause of loss of libido and is treatable.

The Dubai Gynaecology & Fertility Centre has several years of experience in investigating severe male infertility and managing Couples with this problem. If you have any questions about your treatment please let us know. Good luck with your treatment.