Micro-TESE (Microdissection Testicular Sperm Extraction) is a specialized surgical technique used to address azoospermia, a condition where sperm is absent in the ejaculate. This method is particularly effective for cases where azoospermia is not due to a blockage but rather a result of issues within the testicular tissue itself. Micro-TESE involves a delicate procedure to extract sperm directly from the testicles, offering a potential path to successful fertilization.

What is Micro-TESE?

Micro-TESE is a precise, minimally invasive surgical technique performed under general anesthesia. The procedure involves making a small incision in the testicle to access and examine the sperm ducts using a high-powered microscope. The goal is to locate and extract viable sperm for use in assisted reproductive technologies such as IVF. In patients with azoospermia, sperm can be retrieved with a success rate of 40-60%.

Who is a Candidate for Micro-TESE?

Micro-TESE is suitable for men diagnosed with azoospermia, particularly those who do not have sperm in their ejaculate due to intrinsic testicular issues rather than an obstruction. Before proceeding with Micro-TESE, patients undergo genetic testing and hormone evaluations to determine their suitability for the procedure. Azoospermia can result from genetic factors affecting sperm production, and a thorough analysis of the Y chromosome’s regions (a, b, and c) helps determine if sperm production is possible.

How is Micro-TESE Performed?

Micro-TESE is a surgical procedure typically lasting between 1 to 2 hours, though it may extend up to 2.5 hours in some cases due to the detailed examination required. The procedure involves:

  1. General Anesthesia: The surgery is conducted under general anesthesia to ensure patient comfort.

  2. Incision and Inspection: The testicle is opened, and the sperm ducts are inspected using a specialized microscope. The surgeon looks for areas with the potential for sperm production.

  3. Sperm Extraction: Once suitable areas are identified, tissue is removed, and sperm is extracted for use in fertility treatments.

Post-Operative Care for Micro-TESE

Following Micro-TESE, patients should adhere to specific post-operative care instructions to minimize risks such as infection, pain, and bleeding:

  • Rest and Recovery: Ensure adequate rest during the recovery period and follow your doctor’s advice on movement restrictions.

  • Ice Application: Apply ice regularly to reduce swelling and discomfort in the days following surgery.

  • Medication and Clothing: Take prescribed medications as directed and avoid wearing tight underwear. Support the testicles from above to prevent strain.

Can Micro-TESE Be Performed More Than Once?

Micro-TESE can be performed multiple times if necessary. If sperm is successfully retrieved during the initial procedure, it can be frozen and stored for future use. If the first attempt does not yield sufficient or viable sperm, additional procedures may be considered. Typically, a second Micro-TESE increases the likelihood of obtaining sperm by an additional 10-15%.

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