Fertilization and pregnancy rates across different sperm retrieval methods and obstruction etiologies are also comparable If obstruction is located at the level of the epididymis in the presence of a normal vas, the first choice therapy is vaso-epididymostomy. Gently remove the supernatant. Surgical sperm retrieval is indicated when there is no sperm in the ejaculate azoospermia. Once the presence of sperm is documented by microscopic examination of the epididymal aspirate, the fluid is transferred to a conical tube.
The use of a microscope is absolutely necessary in all cases In some vasectomy cases a large part of the vas has been resected, making tensionfree direct anastomose impossible. ICSI also can be performed in azoospermic men where semen sample contains no sperms. However absence of sperm cells is not conclusive for obstruction. Patients with focal spermatogenesis or hypospermatogenesis are also best served with open biopsy or, in some cases, with micro-TESE or micro-dissection TESE. Counting of spermatozoa was not accomplished due to the small quantity of material available. If a fertility problem is mentioned, a refluant varicocele deserves a treatment anyway since the result of the cure is neither dependant upon the size of the veins nor upon the degree of the retrograde flow. Human pregnancy by in vitro fertilization IVF using sperm aspirated from the epididymis.
Surgical Sperm Collection Methods | IVF
Human pregnancy by in-vitro fertilization IVF using sperm aspirated from the epididymis. The use of optical magnification and microsurgical technique allow the preservation of intratesticular blood supply as well as the identification of tubules more likely to harbor sperm production After incision of the scrotum, the testis and the epididymis are exposed. In the aforementioned study, sperm retrieval success rates using percutaneous techniques were similar regardless of the cause of obstruction being vasectomy, CBAVD and post-infectious etiology categories. The albuginea is incised for approximately 1 cm. Occasionally, the epididymis or the seminal vesicles may be enlarged or a cyst can be palpable on rectal examination.
Various surgical techniques, ranging from less invasive percutaneous aspiration to highly invasive open testicular biopsy and micro-dissection TESE, are employed. Re-suspend the pellet in 3. A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia. Microsurgical epididymal sperm aspiration MESA. Depending on the etiology and severity of the underlying condition, none to a fair number of testicular sperm can be retrieved. Re-suspend the pellet in 1.