Kishori IVF


What is the Microsurgical Testicular Sperm Extraction (MicroTESE) Procedure?

Infertility can be an excruciating ordeal for those afflicted. While IVF offers a beacon of hope, male infertility often necessitates a more advanced IVF methodology known as ICSI. Unfortunately, certain men fail to produce a sufficient quantity of sperm even for ICSI. These individuals must resort to surgical sperm retrieval techniques like PESA and TESA, extracting sperm directly from the testes. In extraordinarily rare circumstances, even these surgical interventions prove inadequate due to an extreme scarcity of sperm. For this select group, Micro-TESE provides an advanced and effective solution. Among the myriad IVF treatments, MicroTESE has ascended as the preeminent and most viable option. Let us delve into the intricacies of this groundbreaking procedure.

What Is MicroTESE?

MicroTESE, or Microsurgical Testicular Sperm Extraction, is a surgical technique employed to harvest sperm from the testis. It stands as one of the most efficacious methods of sperm retrieval, particularly in cases of severe infertility such as azoospermia, where sperm production is virtually nonexistent. This procedure is meticulously timed and coordinated with the reproductive endocrinologist, occurring at specified intervals throughout the year.

When Is MicroTESE Recommended?

MicroTESE is specifically recommended for men diagnosed with Non-Obstructive Azoospermia (NOA), a condition characterized by an almost complete absence of sperm in the semen. This condition may stem from inherent testicular failure or insufficient production of hormones like gonadotropins, which are crucial for spermatogenesis, the process of sperm maturation.

How Does MicroTESE Help with NOA?

Even in NOA cases where sperm count is nil or indiscernible, there remains a 60 per cent chance that tiny regions within the testis continue to produce sperm. MicroTESE allows access to these minute tubules, facilitating the extraction of the required sperm quantity.

How Is the MicroTESE Procedure Performed?

MicroTESE is designated for men experiencing sperm production issues, specifically azoospermia. The procedure is conducted under general anaesthesia in an operating room, which involves an operating microscope for precision. It is synchronized with the female partner’s egg retrieval, typically performed the day prior, ensuring the presence of both partners during each other’s procedures. 

MicroTESE has markedly enhanced sperm retrieval rates in azoospermic men, necessitating the removal of minimal testicular tissue. The sperm obtained can also be cryopreserved for future IVF/ICSI procedures.

As an outpatient procedure, MicroTESE does not require an overnight hospital stay. It is executed by a specialist under local or general anaesthesia, such as a urologist or an andrologist. A small incision, approximately 2-3 cm, is made to access the testicular tissues. A surgical microscope, magnifying up to 40 times, is employed to locate and scrutinize the seminiferous tubules, which house the sperm. These tubules, often engorged with sperm, are identified and extracted until adequate amounts are procured. 

The harvested sperm is then utilized for assisted reproductive techniques or cryopreserved for subsequent use. Notably, MicroTESE is invariably coupled with ICSI, wherein a single, viable sperm is injected directly into the egg.

What Are the Advantages of MicroTESE?

MicroTESE is heralded as a superior sperm retrieval method compared to traditional infertility treatments. Research indicates that sperm obtained via MicroTESE is generally of superior quality and quantity. The procedure boasts a success rate of 40-60%, reflecting highly favorable outcomes.

Additional benefits include:

  • Minimal postoperative discomfort and expedited recovery
  • Enhanced potential for cryopreservation of retrieved sperm
  • Reduced chronic alterations to testicular tissues
What Is the Postoperative Care and Recovery Process for MicroTESE?

Recovery following MicroTESE is typically swift, with rapid healing of the scrotal tissues. Most patients experience minimal postoperative pain, though painkillers may be prescribed for comfort. Post-surgery, applying a local ice pack for the first 24 hours can mitigate swelling and discomfort. Patients are advised to avoid strenuous physical activities for up to 10 days post-surgery.

Are There Any Complications Associated with MicroTESE?

MicroTESE is a minor surgical intervention with few complications. Any arising issues, such as hematoma, bleeding, or testicular damage, can generally be managed conservatively.

In summary, MicroTESE represents a sophisticated and efficacious option for men with severe infertility, offering hope where traditional methods fall short.

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