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Does sperm production hurt8/29/2023 ![]() Micro-TESE has limited postoperative complications compared with TESE. Long-term follow-ups are often recommended to prevent these complications. The blood supply to the testis can also be altered during this procedure, potentially reducing supply. This can cause side-effects including muscle weakness, decreased sexual function, anxiety, leading to sleep deficiency. Both procedures can alter the steroid function of the testes causing a decline in serum testosterone levels, which can result in testosterone deficiency. The procedure can cause testicular fibrosis and inflammation, which can reduce testicular function and cause testicular atrophy. TESE can result in testicular abnormalities and scarring of the tissue. Micro-TESE and TESE have risks of postoperative infection, bleeding and pain. TESA is done under local anaesthesia, does not involve an open biopsy and is suitable for patients with obstructive azoospermia. TESE is different to testicular sperm aspiration (TESA). In these cases, micro-TESE is more likely to yield sufficient sperm for use in ICSI. Compared with conventional TESE, micro-TESE has about 1.5-fold higher success in extracting sperm as such, micro-TESE is preferable in cases of non-obstructive azoospermia<, where infertility is caused by a lack of sperm production rather than a blockage. When compared with FNA of the testis, conventional TESE is 2-fold more effective at identifying sperm in men with non-obstructive azoospermia. Samples are re-examined post-surgery to locate and then purify sperm. If none can be identified, biopsies are instead taken at random from a wide range of locations. ![]() This allows exploration of the incision under the microscope to identify areas of tubules more likely to contain more sperm. However, this exposure is much more wide in micro-TESE. Similarly to TESE, an incision is made in the scrotum and surface of the testicle to expose seminiferous tubules. The procedure is more invasive than conventional TESE, requiring general anaesthetic, and usually used only in patients with non-obstructive azoospermia. This allows the surgeon to observe regions of seminiferous tubules of the testes that have more chance of containing spermatozoa. Micro-TESE, or microdissection testicular sperm extraction, includes the use of an operating microscope. įollowing extraction, sperm is often cryogenically preserved for future use, but can also be used fresh. The incision is closed with sutures and each sample is assessed under a microscope to confirm the presence of sperm. Incisions are then made through the outer covering of the testis to retrieve biopsies of seminiferous tubules, which are the structures that contain sperm. The testicle and epidydymis are then visible. An incision in the median raphe of the scrotum is made and continued through the dartos fibres and the tunica vaginalis. Technique Ĭonventional TESE is usually performed under local, or sometimes spinal or general, anaesthesia. TESE can also be used as a fertility preservation option for patients undergoing gender reassignment surgery and who cannot ejaculate sperm. congenital absence of the vas deferens (CAVD). ![]() Obstructive azoospermia can be caused in a variety of ways: More rarely, TESE is used to extract sperm in cases of obstructive azoospermia. However, if azoospermia is related to a disorder of sexual development, such as Klinefelter syndrome, TESE is not used clinically as of 2016, this was in the research phase. Often in these cases, TESE is used as a second option, after prior efforts to treat the azoospermia through hormone therapy have failed. Azoospermia in these patients could be a result of Y chromosome microdeletions, cancer of the testicles or damage to the pituitary gland or hypothalamus, which regulate sperm production. TESE is primarily used for non-obstructive azoospermia, where patients do not have sperm present in the ejaculate but who may produce sperm in the testis. In general, azoospermia can be divided into obstructive and non-obstructive subcategories. TESE is recommended to patients who do not have sperm present in their ejaculate, azoospermia, or who cannot ejaculate at all. TESE is often recommended to patients who cannot produce sperm by ejaculation due to azoospermia. Testicular sperm extraction ( TESE) is a surgical procedure in which a small portion of tissue is removed from the testicle and any viable sperm cells from that tissue are extracted for use in further procedures, most commonly intracytoplasmic sperm injection (ICSI) as part of in vitro fertilisation (IVF). ![]()
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