Infertility and issues related to infertility have been widely discussed topics for a long time.  A very common idea is infertility is related to female reproductive health, success in conception or failure always has been paralleled with woman's health; however, with evolving time, we are now aware that infertility could also be due to issues with the male reproductive system.  Some abnormalities or disorders which interfere with and impair sperm production and function causes infertility.   Nevertheless, developments in the field of Reproductive Medicine have shown miraculous success even in men to whom having a child would have seemed to be next to impossible.

Male-factor infertility

The reproductive system of a male is comprised of many organs namely the testes, scrotum, vas deferens, epididymis, seminal vesicles, and penis.  The normal functioning of each organ is equally important for the successful production and movement of the sperm to result in a successful conception in a female.

The testes of the male reproductive system play an important role as they produce sperms, hence it is of utmost significance to ensure that testes are healthy.   Well, what if you know that your testes are healthy, yet you are facing difficulties in succeeding to father a child.  Nothing to be surprised about, there do exist certain conditions where your testes could be producing the sperms but they are unable to flow into the semen.  Not to leave discouraged and disheartened, thankfully Reproductive Medicine has made wonderful advances enabling men with these conditions also to have a child.  A special technique of sperm retrieval is used in the treatment process during an IVF cycle where the sperm is directly harvested from the testicles and used for fertilization of the egg in a laboratory.  Two such extensively utilized techniques are TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration).

To decide the right method, certain testing needs to be conducted to check if the testes are producing the sperm and if producing, what is the underlying cause of their absence in the ejaculate, and if there is a possibility of retrieval, what technique is to be employed for retrieval.

Sperm retrieval surgically is a possibility in the following cases:

• If sperm production is hindered due to any obstruction.

• Absence of vas deferens.

• If you have had a vasectomy.

• Blockage in the tubes responsible for carrying sperm to the penis.

What is PESA?

PESA is a simple procedure that involves inserting a needle into the epididymis to extract fluid that contains sperm.  The aspirated fluid will then be sent to the laboratory for sperm aspiration.  The sperms extracted from the epididymis require a procedure called ICSI (intracytoplasmic sperm injection), an IVF procedure where the sperm cell is directly injected into the cytoplasm of the egg.  This same-day procedure gives the benefit of not having to make an incision on the body.  PESA is one of the most effective and successful techniques of sperm aspiration.  If your testes are healthy to produce healthy sperms that are not able to make their way into the ejaculate, this same-day procedure would be considered as it does not involve any surgical incision.

What is TESA?

Similar to PESA, testicular sperm aspiration (TESA) is also one of the newest methods used in the treatment of infertility in men.  This technique is widely recommended to men with azoospermia, in which there is a lack of sperm in the ejaculate.  The invention of ICSI (intra-cytoplasmic sperm injection) has made it possible for a number of men with azoospermia to biologically father a child.  This has been a breakthrough procedure in extracting sperm directly from the testis of a male.

The procedure is done by insertion of a needle into the testis and with the aid of negative pressure, fluid and tissue are aspirated.  The sample thus obtained undergoes further processing to retrieve the sperm cells in a laboratory.  In this procedure, the sperm cells do not have to necessarily be mature and travel through the epididymis in order to fertilize the egg and because the sperms are immature, ICSI has to be performed so as to be able to obtain single sperm and inject straight away into the egg for further fertilization to occur and result in the embryo formation.

Both the procedures are helpful in treating the male infertility factor, but there are certain factors to be taken into consideration before deciding which one is ideal for your condition.  This is possible only through a fertility specialist.  Approach the right facility and choose a specialist who can efficiently guide you through your journey to reach your destination of being a biological father.

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