Microsurgical Epididymal Sperm Aspiration (MESA) and Testicular Sperm Extraction (TESE)

Azoospermia is a condition is which sperm is absent from semen. It is associated with up to 20% of male infertility cases and can act as a real obstacle to effective IVF. But there are effective ways of overcoming this problem. MESA and TESE are surgical techniques that enable living, motile sperm to be retrieved in spite of azoospermia. Each differs in the manner of extraction.

In the MESA technique, sperm is withdrawn from the epididymus through a needle by means of mild suction. Typically, this method is used in instances of non-obstructive azoospermia—wherein sperm is absent in semen due to root issues with sperm production itself.

In TESE, sperm is collected from a tissue sample taken from the testis. This technique is ordinarily resorted to when efforts through MESA have failed or in instances of obstructive azoospermia—wherein sperm is absent from semen as a result of blockage in the ejaculation pathway.

Both MESA and TESE are conducted under short-duration general anaesthesia on the day of egg retrieval or one day prior. Each takes approximately 60 minutes to perform, and the male is discharged two to three hours after the procedure. A quantity of the extracted sperm is used in fertilisation, with the remainder being frozen and preserved for future use.

The patient must refrain from food, drink, and smoking for 12 hours before the procedure.