Microdissection Testicular Sperm Extraction is a surgical sperm retrieval procedure applied to men who don’t have sperm in their semen due to non-obstructive azoospermia. The surgery is performed under general anesthesia. The surgeon makes a very small (2-3 cm) incision in the midline of the scrotum, using a high-powered operating microscope (at 30-40X magnification) the seminiferous tubules can be seen more clearly, vividly and fuller. So, the surgeon can better examine the swollen seminiferous tubules, which may contain sperm. Micro-TESE surgery can take 1 hour as it requires the examination of all seminiferous tubules. In micro-TESE, the surgeon takes tissue samples are from 5-10 different regions in both testicles, then tissue samples are examined in the laboratory and mature sperm are searched. Depending on the underlying cause, mature sperm can be obtained from 60% of azoospermic patients in Micro-TESE. Hormone levels are checked before the Micro-TESE. In some cases, hormone therapy may be required 3 months before Micro-TESE. If mature sperm are not found in the micro-TESE procedure, spermatids will be collected for use in the ROSI/ELOSI technique.
Advantages of Micro-TESE includes:
- High sperm retrieval rates
- Reduced acute post-operative complications
- Fewer chronic changes to testicular function
- Fewer complication
