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Friday, 12 September 2014

Surgical sperm collection

Surgical removal of sperms is done in men with no sperms in the semen (azoospermia). The reasons for azoospermia may be due to a blockage in the tubes that carry the sperms from the testes (Vas Deferens) or due to a vasectomy. Some men may also have a congenital absence of the Vas Deferens. Lack of sperms may also result from a slowing or stopping of sperm production in the testes. 

Men who are unable to ejaculate may also require to undergo this procedure. In this scenario PESA is not done to avoid injury to the otherwise normal anatomy.

These procedures are generally done under local anaesthesia either on the same day as the egg collection of the wife or as an stand-alone technique. In the latter case, sperms may be frozen for later use. The disadvantage of freezing is that a significant proportion of sperms are lost in the freeze-thaw process. 

The surgical retrieval sperms is done from either the testes or the epididymis. The procedures that are commonly done are

PESA - Percutaneous Epididymal Sperm Aspiration is commonly used where there is either a blockage or an absent Vas Deferens. By aspirating fluid from the Epididymis, sperms that have been produced by the testes but are unable to go forward can be retrieved and used for fertility treatments and surplus sperms can even be frozen for future use.

TESA - Testicular Sperm Aspiration is employed where there is a slow production of sperms. A needle is used to aspirate fluid from the testes and this fluid is scanned under the microscope for presence of sperms. 

TESE - Testicular Sperm Extraction involves removal of  one or more tubules in which sperm production normally occurs. Sperms are then extracted from these tubules.

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