Micro TESE what and for whom

Micro dissection Testicular Sperm Extraction (micro-TESE) is a refined version of TESE. Instead of removing a random sample of testicular tissue, a skilled surgeon uses an operating microscope to precisely identify areas of the testicles more likely to contain sperm. This allows for a more targeted and minimally invasive approach to sperm retrieval, reducing the risk of damage to the testicular tissue and increasing the chances of finding viable sperm. Micro-TESE is particularly beneficial for men with non-obstructive azoospermia, where sperm production is impaired or absent.

Which patients used MicroTESE

Non-Obstructive Azoospermia (NOA) patients who’s suffering male infertility which can be resolved by retrieval of testicular sperm to be used for ICSI. Micro TESE procedure should be performed to see if a viable sperm can be found in the testis.

How is the procedure carried out?

The testis is cut to obtain a tissue sample. It is a short-term procedure and generally does not require hospitalization after the procedure. There are high sperm retrieval rates with a microTESE (50-55%), except in some cases where large fragmentations (Y microdeletions) and sertoli cell only occur, in some Y chromosomes where sperm production is not or seriously affected. In cases where there is extensive testicular damage, such as in severe cases of Y chromosome micro deletions or Sertoli cell-only syndrome, Micro-TESE may not be able to locate viable sperm. Micro-TESE is methods that sperms are directly retrieved from the testicular germinal epithelium. Tissue samples that are taken from the outer testicular layer by small incisions are referred to the embryology laboratory. The fresh sperm that is retrieved are immediately used for oocyte fertilization with ICSI method at the same day of oocyte retrieval in an IVF cycle.

What are the advantages of Micro TESE procedure?

• Higher success rates in non obstructive azoospermia (NOA): micro-TESE generally has higher success in extracting sperm; as such, micro-TESE is preferable in cases of NOA, where infertility is caused by a lack of sperm production rather than a blockage.
• Larger number of sperm retrieved: Micro-TESE method obtains much more and better quality sperm compared to the previous multiple biopsy method. Relatively higher chance of sperm freezing.

What are the disadvantages of micro-TESE procedure?

• The procedure is more invasive than classical TESE, requiring general anesthetic, and generally used only in patients with non-obstructive azoospermia. The cost of micro-TESE is higher than TESE procedure.
• Operation time is longer.