MESA: Fresh Sperm Retrieval for ICSI in Urology - Urology

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MESA, or Microepididymal Sperm Aspiration, is a surgical procedure used primarily in the field of urology and reproductive medicine to retrieve sperm directly from the epididymis. This technique is particularly beneficial for men who have obstructive azoospermia, a condition where sperm is produced but cannot be released due to blockages in the reproductive tract. MESA is often performed in conjunction with assisted reproductive technologies, such as Intracytoplasmic Sperm Injection (ICSI), which allows for the direct injection of a single sperm into an egg, facilitating fertilization.

In response to your inquiry about whether MESA can be performed at your hospital and if it can be done on the same day as egg retrieval for ICSI, it is important to clarify a few points. First, MESA is typically performed under anesthesia and involves making a small incision to access the epididymis, where sperm is collected. The timing of this procedure in relation to egg retrieval is crucial. Ideally, MESA can be coordinated with the egg retrieval process, allowing for the use of fresh sperm collected during the MESA procedure for ICSI. This approach maximizes the chances of successful fertilization, as fresh sperm generally have higher motility and viability compared to frozen sperm.

However, it is essential to confirm with your specific medical facility whether they have started performing MESA, as there may be logistical considerations, such as the availability of surgical staff and the necessary equipment. If your hospital has not yet implemented MESA, you may need to explore other facilities that offer this service.

Regarding the use of fresh sperm versus frozen sperm, fresh sperm retrieved via MESA is often preferred for ICSI due to its higher quality. Frozen sperm can sometimes experience a decline in motility and viability during the freezing and thawing process. Therefore, using fresh sperm can enhance the chances of successful fertilization and subsequent embryo development.

In cases where MESA is not available, alternative sperm retrieval methods, such as Testicular Sperm Extraction (TESE) or Percutaneous Epididymal Sperm Aspiration (PESA), may be considered. These methods also aim to obtain viable sperm for use in assisted reproductive techniques.

It is also worth noting that the quality of sperm retrieved through MESA can vary based on individual circumstances, including the underlying cause of infertility. For men with conditions like varicocele, which can affect sperm quality, addressing the underlying issue may also improve outcomes.

In summary, MESA is a valuable option for sperm retrieval in the context of ICSI, particularly for men with obstructive azoospermia. Coordinating the timing of MESA with egg retrieval can optimize the chances of successful fertilization. It is advisable to consult with your healthcare provider to discuss the availability of MESA at your facility and to explore the best options for your specific situation. Always remember that personalized medical advice from a qualified healthcare professional is essential for making informed decisions regarding fertility treatments.