Microepididymal sperm aspiration (MES) and testicular sperm extraction (TESE) are outpatient surgical procedures used to harvest sperm from men in special circumstances as part of an IVF-ICSI cycle.
MESA is utilized to obtain sperm in men who have blocked reproductive ducts. These blocks may occur as a result of prior surgery, such as vasectomy, prior infection, or congenital (i.e. born with) absence of the vas deferens. During MESA, I.V. sedation and local anesthesia are provided and a needle placed through the epididymis, the area immediately next to the testis where sperm is held before ejaculation. Sperm is obtained and then used for injection into eggs obtained during the IVF process.
TESE involves performing a biopsy of the testis itself. It is primarily reserved for men that have a problem producing sperm, which is mainly due to genetic reasons. Occasionally, during a MESA attempt, if no sperm is found in the epididymis, then a TESE will be performed to look for sperm in the testis. The anesthesia process for TESE, with I.V. sedation and local anesthesia, is the same as with MESA.
Both MESA and TESE are performed in our office by Drs. Winslow, Duffy, and Freeman.
