For couples facing infertility, the journey to parenthood can be a challenging one. Male infertility accounts for nearly 50% of all infertility cases, with one of the most severe conditions being azoospermia—the complete absence of sperm in the ejaculate. Thankfully, advancements in medical technology have introduced a breakthrough procedure called microdissection testicular sperm extraction (Micro-TESE).

This blog will explore what Micro-TESE is, who it’s for, how it works, and what to expect, all in easy-to-understand terms.

1. What Is Micro-TESE?

Micro-TESE is a specialized surgical procedure designed to retrieve sperm directly from the testes of men with azoospermia. The technique involves using a high-powered surgical microscope to carefully examine the testicular tissue and identify tiny areas where sperm might still be produced.

Unlike traditional sperm extraction methods, Micro-TESE is highly precise, targeting only the specific areas of the testes with the best chance of containing sperm. This not only increases the success rate but also minimizes damage to the testicular tissue.

2. Who Needs Micro-TESE?

Micro-TESE is typically recommended for men with azoospermia, which can occur due to two main reasons:

Non-Obstructive Azoospermia (NOA)

In NOA, sperm production in the testes is severely impaired or completely absent. This can result from:

• Hormonal imbalances
• Genetic conditions
• Testicular damage or failure
• Previous infections or medical treatments

Obstructive Azoospermia (OA)

In OA, sperm production is normal, but a blockage in the reproductive tract prevents sperm from being released. Micro-TESE may be used in cases where less invasive procedures, like needle aspiration, have not been successful.

3. How Does Micro-TESE Work?

Preoperative Preparation

Before the procedure, patients undergo a thorough evaluation, including:

• Blood tests to assess hormone levels
• Genetic testing to identify underlying conditions
• Imaging studies to examine the reproductive organs

If hormone imbalances are identified, doctors may prescribe medication to improve sperm production before attempting Micro-TESE.

The Procedure

Micro-TESE is performed under general anesthesia to ensure the patient is comfortable throughout the surgery. Here’s how it works:

1. Incision: A small incision is made in the scrotum to access the testes.
2. Microscopic Examination: Using a surgical microscope, the surgeon examines the testicular tissue in high detail.
3. Tissue Extraction: Tiny samples of tissue are taken from areas that appear most likely to contain sperm.
4. Sperm Isolation: The extracted tissue is immediately sent to an embryology lab, where specialists carefully search for sperm.

Postoperative Care

After the procedure, patients are advised to:

• Rest and avoid strenuous activities for a few days
• Use prescribed pain relievers if needed
• Follow up with their doctor for results and further recommendations

4. Why Is Micro-TESE So Effective?

The success of Micro-TESE lies in its precision. The use of a microscope allows surgeons to identify the healthiest areas of the testes, which might be missed during traditional sperm retrieval methods.

Key advantages include:

• Higher sperm retrieval rates compared to conventional techniques
• Reduced damage to testicular tissue
• Improved chances of success for assisted reproductive techniques like IVF and ICSI

5. What Happens to the Retrieved Sperm?

Sperm retrieved during Micro-TESE is often used for intracytoplasmic sperm injection (ICSI), a specialized form of in-vitro fertilization (IVF). Here’s how it works:

1. A single sperm cell is injected directly into an egg to achieve fertilization.
2. If fertilization occurs, the resulting embryo is transferred to the woman’s uterus for implantation.

In some cases, if enough sperm is retrieved, it may be frozen (cryopreserved) for future use. This eliminates the need for repeated surgeries.

6. What Are the Risks of Micro-TESE?

Like any surgical procedure, Micro-TESE has some risks. However, these are generally minimal when performed by an experienced surgeon. Potential risks include:

• Swelling or bruising in the scrotum
• Temporary discomfort or pain
• Very rare cases of infection or bleeding

Patients are usually given detailed aftercare instructions to minimize these risks.

7. Success Rates of Micro-TESE

The success of Micro-TESE depends on several factors, including the underlying cause of azoospermia, the patient’s age, and the skill of the medical team. On average:

• Sperm retrieval rates range from 40% to 60% for men with non-obstructive azoospermia.
• Couples using sperm from Micro-TESE for IVF/ICSI have a good chance of achieving pregnancy, depending on the quality of the eggs and sperm.

It’s important to have realistic expectations and discuss your individual case with your doctor.

8. Preparing for Micro-TESE

Preparing for Micro-TESE involves more than just physical readiness. Here are some tips:

Medical Preparation

• Follow all preoperative instructions provided by your doctor.
• Discuss any medications or supplements you’re taking, as some may need to be adjusted.
• If hormone therapy is prescribed, stick to the schedule to optimize your chances of success.

Emotional Preparation

• The journey of infertility can be emotionally challenging. Seek support from your partner, friends, or a counselor.
• Stay informed about the procedure and ask your doctor any questions you may have.

Lifestyle Adjustments

• Quit smoking  as this can negatively impact sperm quality.
• Eat a balanced diet rich in antioxidants, vitamins, and minerals to support overall reproductive health.

9. Is Micro-TESE Right for You?

Micro-TESE is not suitable for every man with azoospermia. Your doctor will evaluate your condition and medical history to determine if this procedure is the best option. Alternative treatments may include hormonal therapy or other sperm retrieval methods.

10. The Role of Expertise in Micro-TESE Success

The success of Micro-TESE largely depends on the experience and expertise of the medical team performing the procedure. Choosing a reputable fertility clinic with skilled surgeons and advanced facilities is crucial for achieving the best outcomes.

Take the Next Step with Dr. Sajjad’s Australian Concept Infertility & Genetics Center

If you or your partner are facing azoospermia, don’t lose hope. At Dr. Sajjad’s Australian Concept Infertility & Genetics Center, we specialize in advanced procedures like Micro-TESE to help couples overcome infertility challenges. Our dedicated team combines cutting-edge technology with compassionate care to guide you through every step of your journey.

Contact us today to schedule a consultation and learn more about how Micro-TESE can bring you closer to your dream of parenthood.