Microdissection Testicular Sperm Extraction: A Solution for Male Infertility? - Urology

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Microdissection Testicular Sperm Extraction (MESA) is indeed a viable option for men facing infertility issues, particularly when conventional sperm retrieval methods are not successful or when sperm quality is severely compromised. In your husband's case, the diagnosis of varicocele, coupled with the abnormal semen analysis results, suggests that there may be significant challenges in achieving natural conception.
The semen analysis you provided indicates a very low sperm count (0.8 million/ml), poor motility (2%), and a low percentage of normally shaped sperm (11%). These factors can severely limit the chances of natural conception, making assisted reproductive techniques necessary. MESA is particularly useful in such scenarios because it allows for the retrieval of sperm directly from the testis, which can be of higher quality than what might be found in the ejaculate.

MESA is performed under a microscope, which allows the surgeon to identify and extract sperm from the seminiferous tubules of the testis. This technique is beneficial for men with obstructive azoospermia (where sperm is produced but not present in the ejaculate) or those with very low sperm counts. The sperm retrieved through MESA can be frozen for future use, which is advantageous for couples who may want to attempt in vitro fertilization (IVF) at a later date.

Regarding your question about whether there are alternative methods for sperm retrieval, it is important to note that while MESA is a highly effective technique, other options exist. For instance, Testicular Sperm Extraction (TESE) is another method where sperm is extracted from the testis, but it may not be as precise as MESA. In cases where sperm quality is extremely low, using sperm from MESA may yield better results for IVF procedures.

As for the availability of MESA at Taoyuan Hospital, it is essential to consult directly with the hospital or the urology department to confirm whether they offer this specific procedure. Not all hospitals have the same capabilities, and it is crucial to ensure that the facility is equipped to perform MESA and has the necessary expertise.

In terms of sperm freezing, yes, sperm retrieved through MESA can be cryopreserved. This allows for the sperm to be stored and used later, which can be particularly helpful if the couple is not ready to proceed with IVF immediately or if there are concerns about sperm quality in the future.

In conclusion, given your husband's current sperm analysis results, MESA appears to be a suitable option for sperm retrieval. It is advisable to have a thorough discussion with a fertility specialist who can provide personalized guidance based on your husband's specific condition and the available options at your local medical facilities. This will help you make an informed decision regarding the best path forward for achieving pregnancy.