Microdissection TESE (Testicular Sperm Extraction)

Microdissection TESE (Testicular Sperm Extraction) Abroad

Over the last decade advances in reproductive medicine have made it possible for men who were previously considered absolutely sterile to father biological children. Thanks to these technologies, the number of sperm needed to fertilize an egg has been reduced from millions to just one sperm per egg. This means that men with very low sperm counts have a chance of effectively conceiving.

Research has shown that even men suffering from Non-Obstructive Azoospermia (NOA), who causes them to have no sperm in the ejaculate due to sperm production problems, actually may have small pockets of sperm production within the testicle. More than 60% of men suffering from NOA produce small amounts of sperm inside the testicle that can be used with IVF/ICSI to create a baby.

A new surgical technique, the Microsurgical Testicular Sperm Extraction or “Micro-TESE”, has been developed to detect sperm in the testicles of men who have poor sperm production. An operating microscope is used to examine the tubules at the time of testicular biopsy and selective remove the more normal appearing tubules.

Causes

One of the main causes for male infertility is Azoospermia, a condition in which viable sperm are not available in the ejaculate. Micro-TESE can help men suffering from this condition avoid the need to use a sperm donor and father a genetically related child. Although they lack sperm in their ejaculate, men with Azoospermia may still have viable sperm residing in their testes. 

Symptoms 

• Blockage in the sperm channels
• Congenital absence of the sperm channels
• Hormonal factors
• Drugs: some drugs particularly used in the treatment of cancer can permanently stop sperm production.
• Infection (after mumps)
• Genetic factors, genes that allow sperm production are on the Y chromosome. Problems in these genes affect sperm production
• Radiation: radiation particularly due to cancer treatment may completely eliminate sperm production sometimes, and this situation may be permanent

Treatment 

Through Micro-TESE the surgeon will remove the normal appearing tubules, which are then opened in a Petri dish containing sperm wash media. The surgeon will look for viable sperm by examining the specimens under the microscope. It can take up to five hours to search for sperm in the specimens. This is a very involved and tedious process, but very thorough and important.

Once the sperm is found, they are then either incubated using the ICSI method and injected into awaiting eggs or frozen for future injection. This advanced technique increases the chances of finding sperm while removing smaller amounts of tissue then a random biopsy, causing less damage.

The procedure can be performed and timed with an egg retrieval/IVF cycle so that the sperm are injected into the eggs without freezing. The best chance of pregnancy is to use fresh sperm obtained just prior to IVF.

The chances of finding sperm using the Micro-TESE technique are higher than 60%. This is twice the chances of finding sperm by non-microsurgical or needle biopsies taken by general urologists.

Benefits

• Effective treatment for male infertility
• Very little pain during the procedure
• Fresh or frozen sperm can be used
• Sperm retrieval rates (SRR) by micro TESE are significantly higher than conventional TESE

Cost

In the US the price for the Micro TESE procedure ranges between $8,900 - $11,000. The prices vary depending on the clinic's location and the surgeon chosen. Traveling abroad can help patients save a lot of money. To make an idea you should know that in Mexico you would pay for this procedure around $900 and in Argentina around $2,500.

Doctors

Micro-TESE is an advanced technique that requires the skill, experience and understanding of an expert micro-surgeon who is very familiar with testicular tissue. The combination of using the operating microscope, dissecting the testicular tubules and having trained personnel available to search for sperm can make the difference between success and failure for many couples.

If you need more information about the Microdissection TESE (Testicular Sperm Extraction), please contact us!