Surgery for azoospermia
Testicular biopsy - is a surgical method of obtaining sperm from the testicle or epididymis. This method is used in cases when it is impossible to get male sex cells naturally (in cases of azoospermia).
There are two types of biopsy - open and closed (puncture).
Closed percutaneous needle testicle biopsy (TESA) or epididymis (PESA) is provided mainly at obstructive azoospermia, when spermatozoas are normally produced in the testes and ripen in the epididymis, but because of the obstacles in the ejaculatory ducts naturally do not pass or at congenital absence of ejaculatory ducts. The procedure does not require the inpatient observation. The essence of the procedure is that with the puncture needle with a syringe, the material containing spermatozoas, is extracted from the testicle or epididymis.
Open testicle biopsy (TESE) is conducted at obstructive azoospermia or if you cannot get the material with the help of TESA and PESA. This surgery is performed in a hospital, but on the next day the patient can go home. The surgery is performed under intravenous anesthesia, a small incision is made in the scrotum and part of a testicle is cut off and then is given to embryologist to find the sperm. During carrying out these methods, testicular tissue is taken randomly.
In the IVF Center of professor Feskov ® ultra approach to obtain sperm at any form of azoospermia is used - operation microTESE. This microsurgical operation is performed using a special microscope, which increases the operating field in 25 times. The operation is performed under the i/v anesthesia, widely exposes the testicular tissue and surgeon-andrologist conducts a thorough examination of testicular tubules, looking for areas where there may be spermatozoas. Patients with nonobstructive azoospermia normal sperm maturation takes place in small individual areas, which is the problem of surgeon- andrologist to find themAccordingly, such a procedure for these patients - is the only way to become parents. After finding the section, surgeon andrologist highlights and cuts part of the tubule and gives to embryologist, who immediately looks through this tubule and selects suitable sperm for artificial insemination. This operation increases the chances of finding sperm at patients with azoospermia near 80%.
At obstructive azoospermia no spermatozoas are in the ejaculate, and they are normally produced by the testicles, however, due to variety of reasons do not pass along seminiferous ways.
In this case, it is performed a surgery to restore patency of seminiferous ways - vazoepididimoanastomoz. In 50% of cases spermatozoas appear in the seminiferous ways and pregnancy is possible by natural way.