Sperm Retrieval Procedures
TESA/TESE/Micro TESE/MESA/PESA
Explanation of Procedures
There are a variety of different procedures available to retrieve sperm for planned IVF/ICSI.
Testicular sperm aspiration (TESA)
Testicular sperm aspiration (TESA) is a procedure performed for men who are having sperm retrieved for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated. TESA is performed for men with obstructive azoospermia (s/p vasectomy). Often TESA doesn’t provide enough tissue/sperm and an open testis biopsy is needed.
Percutaneous Epididymal Sperm Aspiration (PESA)
PESA is a procedure performed for men who are having sperm retrieved for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) who have obstructive azoospermia from either a prior vasectomy or infection. It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval.
Testicular sperm extraction (TESE)/Testis biopsy/Testis mapping
TESE/testis biopsy/testis mapping are procedures performed for men who have testis failure. The procedure is performed to see if there are sperm present as well as for pathologic diagnosis to evaluate for malignancy. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. TESE is usually performed in the operating room with sedation, but can be performed in the office with local anesthesia alone.. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI. This diagnostic biopsy is usually performed to evaluate for an obstructive etiology – microdissection TESE has replaced this as the optimal form of retrieval for testis failure patients.
Microepididymal Sperm Aspiration (MESA)
MESA is a procedure performed for men who have vasal or epididymal obstruction (s/p vasectomy, cystic fibrosis). It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. MESA is performed in the operating room with general anesthesia under the operating microscope. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI.
Microdissection TESE (microdissection testicular sperm extraction)
Microscopic TESE is a procedure performed for men who have testis failure. Microdissection TESE is performed in the operating room with general anesthesia under the operating microscope. Patients cryopreserve sperm during this procedure for future IVF/ICSI.
Post-Operative Instructions
Please review the instructions below to assist in your recovery from your scrotal surgery - these are general guidelines
·
Wear the scrotal support for at least one week following the procedure.
Wear the scrotal support for at least one week following the procedure.·Place an ice pack (a bag of frozen peas works well) inside scrotal support on top of gauze dressing – change every few hours until bedtime the day of the procedure.
Place an ice pack (a bag of frozen peas works well) inside scrotal support on top of gauze dressing – change every few hours until bedtime the day of the procedure.·Keep the gauze and fluff dressing in place for one day.
Keep the gauze and fluff dressing in place for one day.·Relax and rest for one to two days following your procedure. Avoid excessive walking, sitting for prolonged periods of time, and unnecessary exertion. You will recover quicker and easier if you take it easy for these days immediately post-op.
Relax and rest for one to two days following your procedure. Avoid excessive walking, sitting for prolonged periods of time, and unnecessary exertion. You will recover quicker and easier if you take it easy for these days immediately post-op.·Avoid exercise (no running, heavy lifting, straining, etc.) for one to two weeks. Avoid straddle activities like cycling, horseback riding for at least three weeks.
Avoid exercise (no running, heavy lifting, straining, etc.) for one to two weeks. Avoid straddle activities like cycling, horseback riding for at least three weeks.·It is expected to have a small amount of blood stain the gauze dressing. Sometimes the incision may separate slightly before healing. There may be some swelling and firmness at the site of the incisions.
It is expected to have a small amount of blood stain the gauze dressing. Sometimes the incision may separate slightly before healing. There may be some swelling and firmness at the site of the incisions.·Take the antibiotic as prescribed to help prevent infection.
Take the antibiotic as prescribed to help prevent infection.·You may take the narcotic medication as prescribed for discomfort or you may take over-the-counter motrin or advil as directed. Do not take any aspirin products for two weeks following the procedure.
You may take the narcotic medication as prescribed for discomfort or you may take over-the-counter motrin or advil as directed. Do not take any aspirin products for two weeks following the procedure.·You may shower tomorrow– pat your scrotum dry, do not rub. Do not take a bath or go swimming for two weeks.
You may shower tomorrow– pat your scrotum dry, do not rub. Do not take a bath or go swimming for two weeks.·The incisions were closed with absorbable suture. This suture dissolves on its own and does not need to be removed. No incisions were made if you underwent a TESA or PESA procedure.
The incisions were closed with absorbable suture. This suture dissolves on its own and does not need to be removed. No incisions were made if you underwent a TESA or PESA procedure.·Abstain from intercourse for at least one week or until discomfort resolves, whichever is longer.
Abstain from intercourse for at least one week or until discomfort resolves, whichever is longer. Karen Elizabeth Boyle, M.D.
Reproductive Medicine & Surgery, Sexuality and Aesthetics
Contact Us
Karen E. Boyle, M.D.
Phone: 877-290-5055
Fax: 410-825-5811
Chesapeake Urology Associates at Greater Baltimore Medical Center (GBMC)
Physicians Pavilion North
6535 North Charles Street, Suite 625
Baltimore, MD 21204
