Male Infertility Treatment (PESA/TESE)
What is male infertility? Causes of infertility
Male infertility refers to a situation where a couple has lived together for more than one year without taking any contraceptive measures, and the woman is infertile due to factors on the male side. It involves semen abnormalities, spermatogenesis dysfunction, vas deferens obstruction, sexual dysfunction and other aspects that affect conception. If sperm cells are not found in the semen, it should be noted that sperm is produced by hormones regulated by the pituitary gland, stored in the epididymis, and discharged through the urethra during intercourse. Male infertility may be caused by two main reasons: one is obstruction of sperm transport, such as obstructive azoospermia caused by vasectomy; the other is impaired sperm production, that is, non-obstructive azoospermia.
Treatment of male infertility
- When treating male infertility, the doctor's first task is to find out the cause, and the key is to determine whether it is caused by testicular problems. The testicles are the "factory" for sperm production, and they may not be able to produce sperm (non-obstructive azoospermia) or have poor sperm transport due to blockage (obstructive azoospermia).
- If the cause is impaired spermatogenesis, treatment is challenging; although there are drugs that can stimulate spermatogenesis, the expected effects are poor.
- If the infertility is caused by ejaculatory duct obstruction, the treatment is relatively simple. The doctor will use a small needle to extract semen from the epididymis or aspirate tissue from the testicles, select sperm cells, and then use ICSI (intracytoplasmic sperm injection) to combine with egg cells. This method is very effective.
Treatment
There are four main methods of sperm collection:
- PESA (percutaneous epididymal sperm aspiration) involves inserting a needle through the testicular skin into the epididymis to aspirate sperm, which are then used for ICSI.
- TESE (testicular sperm extraction) is a surgical procedure to remove a small piece of testicular tissue and isolate sperm from it before ICSI.
- TESA (testicular sperm aspiration), in which a needle is inserted into the testicle through a puncture in the testicular skin, and sperm is aspirated before ICSI is performed.
- MESA (microsurgical epididymal sperm aspiration) involves surgically inserting a needle into the epididymis and aspirating sperm for ICSI.
PESA/TESE Procedure
The PESA/TESE procedure is performed under anesthesia administered by an anesthesiologist and you will not feel any pain during the procedure. After the procedure, you will be observed in the recovery room for 2 hours. You can go back home and continue your normal daily activities, but you should avoid strenuous exercise for 1-2 weeks to prevent direct impact on the scrotum. If you have PESA/TESA, the wound is as small as a blood collection needle hole; if you have TESE/MESA, there will be a small wound of about 0.5 cm.
