Azoospermia means absence of sperm in the semen. It could be of 2 types; Obstructive or Non-obstructive. Even if there is no sperm in the semen, it is now possible to retrieve some sperm by using certain specialized surgical techniques. The sperm so obtained can be used for ICSI. This allows men with fertility issues to father their own biological child/children without opting for a donor sperm.
Sometimes there is absence of sperm in the ejaculate due to blockage in epididymis (a narrow tube inside the scrotum, where sperm are stored and mature). This means that although sperm is produced it cannot be released outside the body. There are some techniques can be used to retrieve these sperm that remain inside the testes. These are carried out under local anaesthesia.
• TESA (testicular sperm aspiration) : This involves placing a needle attached to a syringe through the skin of the scrotum and simply drawing out the fluid inside the testis.
• PESA (percutaneous epididymal sperm aspiration) : This involves placing the needle directly into the epididymis and drawing out the fluid.
• Percutaneous biopsy of testis : This involves using a larger needle is used to biopsy testicular tissue and it usually extracts a larger number of sperm.
• MESA (microsurgical epididymal sperm aspiration) : Here an operating microscope is used to locate the tubules of the epididymis precisely, so that large numbers of sperm can be extracted
Sometimes even in the absence of any blockage in the epididymis, there is no sperm in the semen. This usually indicates a problem with the process of sperm production and points to testicular failure. In such cases more advanced surgical techniques are adopted to retrieve sperm.
• TESE (testicular sperm extraction) : This involves removing tiny quantities of testicular tissue from several regions of the testicle and then retrieving sperm from these using a microscope.
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