Sperm retrieval techniques in infertility treatment

The article is professionally consulted by Bachelor Tran Hue Tran - IVF Specialist - Reproductive Support Center - Vinmec Times City International Hospital.

Infertility in men is increasing day by day, so the use of fertility aids is getting more and more attention. Infertility cases but no sperm in the semen for treatment need to get sperm somehow, some measures are applied to get sperm that are said to be the saviors for men who want to have sex. but cannot obtain sperm by natural means.

There are many reasons that lead to male infertility, but among them, the unfortunate few do not have sperm in their semen. It can be due to the patient not having a vas deferens, blocked vas deferens or because the testicles do not produce sperm. Regardless of the cause, when treating infertility, it is necessary to obtain sperm in many different ways depending on each case to apply appropriate measures. The purpose of sperm collection is:
Select the best quality sperm for in vitro fertilization. Collect enough sperm for immediate use for in vitro fertilization and freeze for future use if needed. Minimize damage to the vas deferens so as not to make it difficult for future sperm aspiration or vasectomy. SEE ALSO: Assisted reproductive techniques are performed at Vinmec
Hospital

There are many techniques of sperm collection used in practice. With each method of sperm collection, there are different advantages and disadvantages, depending on the actual condition of the disease, the doctor has the most appropriate sperm collection indications, helping to improve efficiency and reduce the risk of complications. . Grave
2.1. Microsurgical epididymectomy (MESA) Microsurgical epididymal spermatogenesis is a surgical method of sperm retrieval and collection in the epididymis. This is the first method to be successfully applied in people with no sperm in the semen due to congenital vasectomy. The success rate in obtaining sperm using MESA is usually 90% or higher.
When performing this technique, the patient is given local anesthesia with pre-coordinated anesthesia. The scrotal skin on the epididymis side was cut horizontally, cut the epididymis, opened the epididymis, exposed the epididymis, and aspirated sperm-containing fluid from the epididymis with a syringe. The epididymis aspirate is examined under a stereo microscope for sperm. Complications that may occur after the MESA method are surgical site infections due to inadequate aseptic care. It is necessary to clean the incision, change the dressing twice a day and wash it 2 to 3 times with an antiseptic solution, combined with antibiotics.
2.2. Percutaneous Epididymal Sperm Aspiration (PESA) Similar to microsurgical epididymal sperm collection, this method also removes the testicles from the epididymis. But the difference is that this method uses a fine needle to aspirate the epididymis without opening the scrotum, so it is less invasive than MESA, can be performed with local anesthesia, with a success rate of about 65%. . The advantage compared to MESA is that it is less invasive, can be performed many times, is simpler to perform, and the collected sperm samples are often less mixed with blood and less dead cells.
Most of this percutaneous epididymal sperm collection method is uncomplicated, if any, it is usually mild and can go away after a few days. There may be a slight swelling of the scrotum for a few days after a sperm aspiration or a hematoma in the scrotum, but it is usually mild and clears up after a few days.

2.3. Testicular Sperm Aspiration (TESA) This technique uses a needle to penetrate the skin into the testicular tissue and slowly aspirate the tissue sample. Testicular tissues are shredded and sperm examined under an inverted microscope. This is a simple, easy to perform, minimally invasive technique and may not require general anesthesia. The sperm collection rate in those with normal spermatogenesis is over 80%.
After aspiration sperm with TESA method, patients usually only need to take ordinary pain relief for the first few days, no need for antibiotics. With this method, complications are rare and usually mild.
MORE: Testicular surgery for sperm
2.4. Microdissection Testicular Sperm Extraction (TESE) This technique is preferred in patients with spermatogenesis disorders who have had epididymectomy but failed to obtain sperm. sperm. Compared with the method of sperm aspiration from testicular tissue, this method is more invasive, but the rate of sperm collection is very high, especially in cases of spermatogenesis disorders, this method is preferred. more useful than TESA, in addition, testicular tissue samples can be frozen for later use.
After performing the technique, men are treated with wound care, daily dressing changes, and need to use birth control to prevent bacterial superinfection and common pain relievers are used in the first few days.
Some complications can occur after performing TESE such as swelling of the scrotum, infection of the surgical site, epididymitis that can occur after sperm collection.
Usually, depending on the patient's case, the doctor can choose the appropriate method of sperm collection to increase the rate of sperm collection. To increase the effectiveness and success rate of these methods, patients should perform at reputable specialized facilities, with qualified and experienced doctors.

Vinmec IVF Reproductive Center is the address of infertility treatment - infertility is chosen by many couples. So far, the Center has performed fertility support for over 1000 infertile couples with a success rate of over 40%.
The world's leading advanced assisted reproductive technology with high efficiency: Using advanced techniques in assisted reproduction helps people with poor sperm quality still be able to have children, reducing the rate of genetic abnormalities In embryos on day 5, immunological evaluation of the uterine lining helps patients with multiple implantation failures have a higher chance of success, accurate embryo genetic screening and diagnosis, and reduce the rate of multiple pregnancies and stop pregnancy. The success rate is over 40%, this rate is equivalent to developed countries such as UK, USA, Australia. 1000 babies were born from IVF at Vinmec. Comprehensive - professional care service: As the leading modern center in Vietnam, applying a treatment process that coordinates comprehensive examination, combining both male and female obstetrics and gynecology to offer the optimal plan for each patient. case. Comprehensive care from infancy to adulthood. Private examination space, customers are consulted and guided specifically and fully by experts. Well-trained and experienced staff: The team of doctors are leading experts in the field of obstetrics and gynecology in the country and internationally, trained at famous fertility centers around the world. world. With a high level of expertise and extensive experience, IVF's staff is capable of synchronously and comprehensively deploying the most advanced assisted reproductive techniques today, helping to realize the dream of becoming a parent. of hundreds of families across Vietnam. System of facilities and modern equipment: Ensure the best embryo culture conditions such as: clean room system level I international standard ISO 14644-1; The culture room is designed with one-way, positive pressure blowing clean air and the culture cabinet system has many separate culture chambers equipped with a time lapse camera inside the cabinet without disturbing the culture conditions.. To examine and Infertility and infertility treatment with leading doctors at IVF - Vinmec International General Hospital, please click the "Contact Us" button on the website, or register for an online examination.