Thanks to new technological advances today, such as sperm extraction, more couples than ever are finding success in conceiving a baby, even when faced with obstacles that seem insurmountable. Originally developed to help men who were afflicted with a congenital absence of the vas deferens, sperm extraction is now used in the cases of failed vasectomy reversals and most notably, in cases of obstructive azoospermia.
What Is Obstructive Azoospermia?
Azoospermia is the lack of viable sperm in the semen. Obstructive azoospermia is when this happens due to an obstruction of the epididymis or tube that carries the semen. Typically in cases of obstructive azoospermia, the man is producing viable sperm, it is just not getting where it needs to go. This can be due to a number of factors, including scarring, trauma, infection or defects from birth.
Obstructive Azoospermia and Sperm Extraction
There are surgical procedures available to repair some types of damage to the epididymis, but because of the complexity and delicate nature of the tissue involved, it is not always successful. In other cases, the damage may not be repairable at all, and in others, surgery is contraindicated. This has been sad news to couples trying to conceive, but with sperm extraction, viable sperm are able to be located and harvested for IVF with great results. It used to be with a diagnosis of obstructive azoospermia, a couple was out of options, but not anymore.
Understanding Sperm Extraction
Sperm extraction is exactly what it sounds like. There are different versions of the procedure, but it is basically the same. All procedures can be conducted in a doctor’s office under local anesthesia.
- PESA: Percutaneous Epididymal Sperm Aspiration – tissue from the testes is extracted through a very small needle, called a butterfly. No incision is needed and there is minimal blood loss, if any. Local anesthesia is used, and the procedure is considered painless.
- TESE: Testicular Sperm Extraction – in this procedure, a tiny piece of the testicular tissue is extracted, which includes enough for biopsy and for sperm retrieval.
- MESA: Micro-Epididymal Sperm Extraction – this is a procedure that is usually performed on an outpatient basis under local anesthesia through a small incision. If the sperm numbers are sufficient, the sample can be frozen for more than one attempt at IVF.
All three procedures can be combined with IVF (in-vitro fertilization) and ICSI (intracytoplasmic sperm injection), and in many cases there are enough sperm retrieved by the sperm extraction to freeze for future attempts should the first one fail.
