Male Infertility-PESA & TESA Treatments – New Hope for Azoospermia Patients!

• What is Azoospermia?
• Is Azoospermia Common?
• How is the azoospermia condition that causes male infertility?
• Causes of Azoospermia
• PESA & TESA Treatments
• Who can benefit from PESA or TESA?
• How (PESA/TESA) Surgically-aspirated Sperms are used?
• Success rates

Did You Know?

40% of Infertility Cases are Male factor-related!

A Healthy Man Produces 70-150 Million Sperm Every day!

Sperms Have a Life cycle of 3 Months & Can Live 3-6 Days inside a Woman’s Body!

We all know the fact that it takes an egg and a sperm to make a baby, then why is it so unlikely to happen while millions of sperms with each ejaculation? According to the ASRM-American Society of Reproductive Medicine, 1 in 8 couples are suffering from infertility, and roughly 30-40% of the time it is completely due to sperm issues.

What is Azoospermia?

Azoospermia is a condition where there are no sperms in the ejaculate. There are two types of azoospermia, that are  “obstructive” and “non-obstructive”. In case of obstructive, there may be a blockage preventing sperm from entering the ejaculate. And in a non-obstructive one,  it could be because of decreased production of sperm by the testis. 

Is Azoospermia Common?

Yes, in 10% of infertile men, around 1% of men have azoospermia and this issue results in no direct symptoms and can only be diagnosed through clinical tests.

How is the azoospermia condition that causes male infertility?

15% of male factor infertility attribute their main cause to azoospermia. It is the major cause of male factor fertility when a man’s semen (ejaculate) has no measurable sperm. Usually, the testicles in the men’s scrotum produce sperms. 

The sperms flow through the reproductive system to mix with the semen. Semen is the thick-white fluid released from the penis at the time of ejaculation. At MotherToBe fertility clinic in Hyderabad, we are pioneers in azoospermia treatment and sperm extraction procedures. We curate highly personalized treatment plans to help return fertility potential to our patients.

Causes of Azoospermia

There are many potential causes, including Genetic conditions like
Klinefelter’s syndrome
Anatomical abnormalities- varicoceles or the absence of vas deferens on each side
Cancer treatments such as chemotherapy/radiation
Recreational drugs (narcotics)
Vasectomy
Poor testicular development as a child/environmental toxins.

PESA & TESA Treatments

The harvesting of sperm using surgical techniques is done for many reasons. Some these include:

• If a man is not able to ejaculate successfully
• If there is any obstruction present in the tubes that may carry the sperm outwards in cases of a failed vasectomy reversal

These are two popular techniques that exist for surgical sperm retrieval-PESA & TESA and these are routinely performed procedures that allow the patient to return to work the following day.

MotherToBe fertility center of Hyderabad combines a commitment to compassionate care with the latest assisted technology and cutting-edge fertility treatments.

PESA-(Percutaneous Epididymal Aspiration)

If there is a congenital absence of the vas deferens or a blockage in the epididymis, is the cause for azoospermia (no sperm in the semen) then PESA is indicated for obtaining sperm. A very fine needle is inserted into the epididymis and later the sperms are aspirated. This procedure requires no incision and is performed under local anesthesia, and the patient can get back to work on the very same day.

TESA-(Testicular Sperm Aspiration)

In some men, the production of sperms is very low & no sperms are seen in the semen. TESA- Testicular Sperm Aspiration is one of the ways to obtain the few sperms that are available in the testis. Using local anesthesia, a needle is carefully inserted into the testis to get some tissue.  This testis tissue is dissected and aspirated in the embryology laboratory and then a few sperms are obtained from the tissue that might be used for ICSI treatment or cryopreserved for later use.

Who can benefit from PESA or TESA?

Men with:
Testicular issues resulting in poor sperm production
An irreversible genital tract obstruction
Congenital absence (absence of vas deferens)
Unsuccessful vasectomy reversal

How (PESA/TESA) Surgically-aspirated Sperms are used?

The number of sperms retrieved using PESA/TESA are usually very low in the count when compared to the number present in an ejaculate. Hence the sperms are obvious to be used in combination with specific assisted procedures such as IVF with ICSI (Intracytoplasmic Sperm Injection). Surgically retrieved sperm samples could be rarely suitable for use in IUI. And sometimes, if enough sperms are retrieved, some can be frozen for later use in ICSI cycles.

Success rates

IVF-ICSI treatment using sperms obtained from PESA & TESA is a commonly performed procedures which have good success rates and it is around 30-35% for each treatment cycle.

The Takeaway

Hearing the words “no sperm count” or being diagnosed with azoospermia can be scary. But no worries, having this condition does not mean that you can not have your own biological children.

It is important to understand what is causing the issue and after discussing & addressing the cause, your andrologist or fertility doctor may have varied treatment options that could possibly correct the blockage. Otherwise, standard procedures such as IVF may help you achieve success in conception with your partner.

Dealing with sperm-related fertility issues or interested in learning more about how PESA /TESA can help you through your fertility journey?

Our expert andrologists and fertility specialists will help you!

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