SPERM
ASPIRATION/EXTRACTION
Recent breakthrough in IVF enables us to achieve pregnancy with a very
small number of sperm. In men with production problems or obstruction
not amenable to surgical reconstruction, directly obtaining sperm from
the testicle or epididymis for IVF is the only option for biological
parenthood.
Sperm
aspiration/extraction with IVF/ICSI is an alternative to surgical reconstruction.
There are pros and cons for each approach; in my opinion, vasectomy
reversal is more appropriate for most men, if one considers the likelihood
of success and overall costs.
Testicular
and epididymal sperm are functionally immature. They are not very motile
and most do not have the ability to home in on the eggs, even if they
are placed together in a test tube. They must be directly injected into
the eggs to achieve fertilization through a procedure called IVF/ICSI.
Testicular
and epididymal sperm cannot be used for intrauterine insemination due
to their functional immaturity and the low number of such sperm retrievable.
Their use requires IVF/ICSI.
The
sperm may be sucked out with a small needle (aspiration) or processed
out from a small piece of testis tissue (extraction). Aspiration can
only be used in men with normal sperm production; it is less traumatic
but removes only a very small number of sperm, too few for sperm banking,
but sufficient for immediate use.
We
strongly recommend that you become well-informed of all aspects of these
options before reaching a decision. We are here to help you, and we
look forward to the opportunity to discuss with you the various options
available and answer any questions you may have.
I
do perform microscopic epididymal sperm aspiration (MESA) and TESA.
We have a state of the art IVF team and routinely perform MESA and ICSI
for IVF
