Microepididymal sperm aspiration (MESA) - Male Infertility Treatment in India
Microepididymal sperm aspiration (MESA) has perhaps been the procedure most commonly performed in men with vasal obstruction. A scrotal skin incision is made, and the testis and epididymis are exposed. Using an operating microscope, a single epididymal tubule is opened and sperm aspirated.
This procedure may be performed with a general anesthetic, or a local anesthetic with intravenous sedation. An operating microscope is used to examine the very small tubules of the epididymis that contain the sperm. A dilated tubule is opened and the fluid is collected and examined for the presence and quality of sperm.
All of the sperm containing fluid is collected and taken to the IVF lab for processing, use and freezing. If the fluid is devoid of sperm or only dead sperm are found, then another area of the epididymis is sampled. This is done until enough sperm are obtained to use and to store for future use.
Adequate numbers of sperm are often retrieved allowing for cryopreservation and future ICSI cycles. With the advent of microsurgical epididymal sperm aspiration (MESA), sperm are retrieved in higher numbers than with PESA, allowing for cryopreservation of large numbers of sperm.
Which Option is Best for Us ?
Having so many options is great because "one size does not fit all." A comprehensive male fertility evaluation and a careful discussion with you and your partner will determine which option is the safest and the most efficient way to locate and retrieve sperm for you. Each option has its advantages and disadvantages:
Option
Advantages
Disadvantages
MESA *
? Blood contamination
Lots of sperm back/? Retrieval rates
? Risk of hematoma
Best pregnancy rates
Requires microsurgery expertise
? Cost
General anesthesia
Requires scrotal exploration
? Post-operative discomfort
PESA
No microsurgery expertise required
Local or general anesthesia
Few instruments required
Fast/Repeatable
Minimal post-operative discomfort
? Cost
Feasiblility depends on anatomy
Less sperm back
Blood contamination
? Risk of hematoma
Damage to adjacent tissues
TESA
No microsurgery expertise required
Local or general anesthesia
Few instruments required
Fast/Repeatable
Minimal post-operative discomfort
? Cost
Less sperm back
Blood contamination
? Risk of hematoma
Risk of testicular damage/atrophy
TESE
No microsurgery expertise required
Local or general anesthesia
Few instruments required
Fast/Repeatable
If non-obstructive azoospermia,
Then less sperm back.
Risk of testicular damage/atrophy
Scrotal exploration required
Micro-TESE*
Few instruments required
Best for Non-Obstructive Azoospermia
Microsurgical expertise required.
General anesthesia
Not fast/Time consuming
Scrotal exploration required
??? Cost
?? Risk of testicular damage
?? Post-operative discomfort
Minimally repeatable
* Requires microsurgical expertise with fellowship-training preferable.
For more information, medical assessment and medical quote
send your detailed medical history and medical reports
as email attachment to
Email : - info@wecareindia.com
Call: +91 9029304141 (10 am. To 8 pm. IST)
(Only for international patients seeking treatment in India)
For a detailed evaluation send patient’s medical reports / X rays / doctors notes to info@wecareindia.com
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Microepididymal sperm aspiration (MESA) has perhaps been the procedure most commonly performed in men with vasal obstruction. A scrotal skin incision is made, and the testis and epididymis are exposed. Using an operating microscope, a single epididymal tubule is opened and sperm aspirated.
