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PESA was twice repeated for 15 patients, 3 times for 5 patients, and 4 times for 1 patient. Four patients that did not use their samples requested the elimination of the material. In 14 PESA procedures, it was not possible to find spermatozoa; in these cases, the patients opted for accomplishing the procedure of testicular sperm aspiration TESA. Additionally, spermatozoa collected through PESA can be cryopreserved. Sidney Glina; Jorge B.
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Percutaneous epididymal sperm aspiration
Sperm Retrieval Procedures | Johns Hopkins Medicine
Try out PMC Labs and tell us what you think. Learn More. Microsurgical epididymal sperm aspiration MESA refers to retrieval of sperm-containing fluid from optimal areas of the epididymis that are selected and sampled using high-power optical magnification provided by an operating microscope. Retrieved sperm are subsequently used for intracytoplasmic sperm injection ICSI to induce fertilization and pregnancy. MESA is considered by many experts to be the gold standard technique for sperm retrieval in men with obstructive azoospermia given its high yield of quality sperm, excellent reported fertilization and pregnancy rates, and low risk of complications. Herein we present an overview of the evaluation of candidate patients for MESA, the technical performance of the procedure and the outcomes that have been reported. Technical refinements in sperm retrieval methods and the application of intracytoplasmic sperm injection ICSI have enabled biological paternity in azoospermic men who were considered untreatable 20 years ago.
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Laboratory techniques are used to remove contaminants, cellular debris, and red blood cells following collection of the epididymal fluid or testicular tissue. In this article, we review the surgical procedures for retrieving spermatozoa from both the epididymis and the testicle and provide technical details of the commonly used methods. A critical analysis of the advantages and limitations of the current surgical methods to retrieve sperm from males with obstructive and non-obstructive azoospermia is presented along with an overview of the laboratory techniques routinely used to process surgically-retrieved sperm. Lastly, we summarize the results from the current literature of sperm retrieval, as well as the clinical outcome of ICSI in the clinical scenario of obstructive and non-obstructive azoospermia.
There are many ways to get sperm. The method used depends on why sperm aren't in the semen, what the patient wants, and the surgeon's skill. At the base of the penis, sperm and testosterone male hormone are made in the scrotum's 2 testicles. The sperm leave the testicles through a coiled tube called the epididymis.