- May 19, 2020
- Posted by: Prof Dr Coşkun Şahin
- Category: Infertility
What is Infertility?
It is said that couples cannot have children with unprotected and regular sexual intercourse for 1 year.
What Is Azoospermia?
It is the case that there is no sperm in the semen. The absence of live sperm in the semen means that the person cannot have children with natural methods. However, thanks to the newly developed treatment methods, men with azoospermia can also have children. Reproductive cells may be present in the ovaries of many men who have no semen in the semen or who are 100% inactive, even if the sperm count is normal.
The absence of sperm cells in the semen can be due to various reasons;
Blockage in sperm ducts.
Sperm ducts are not congenital.
Genetic causes; Genes that produce sperm in men are on the Y chromosome. The problem with these genes affects sperm production.
Radiation, especially radiation due to cancer treatment can sometimes eliminate sperm production completely and this may be permanent.
Drugs, especially some drugs used in cancer treatment, can stop sperm production permanently. Infection (after mumps)
What are the Methods of Obtaining Surgical Sperm Used in the Treatment of Azospermia?
TESA, TESE and micro-TESE methods are the most frequently used surgical methods applied in these cases.
TESA (Testicular Sperm Aspiration);
It is the surgical method in which sperm is searched in the testicles by aspiration with the help of a special injector.
During the procedure, the area is desensitized with a local anesthetic agent and the needle is entered into the testicle and sperm is collected from the sperm ducts by needle. This procedure is a procedure that has normal sperm production values, but does not require any sperm in the ejaculate, and does not require any incision line and Surgical sutures
(TESA) What are the Advantages of Testicular Sperm Aspiration?
There are no surgical incisions and stitches. There are no situations like drug use infection risk. After the procedure, he can continue his normal life.
TESE (Testicular Sperm Extraction);
It is the method of removing parts from the testicles by surgical intervention when the results cannot be obtained with the TESA method or in cases where there is a lack of advanced sperm production. The operation is performed under local anesthesia, the patient can continue his normal life on the same day. When this operation is under a microscope, this is called microscopic TESE.
Micro TESE (Micro Testicular Sperm Extraction)
TESE is to obtain sperm from the tissues taken from the testicles of patients with azoosperm, in which there is no sperm cell in the ejaculate (semen).
How to Make Micro Tese?
The procedure is applied under anesthesia. takes about 1-2 hours. In this process applied under the microscope, tissue samples are taken from 4 different points of the testicle. The tissue samples obtained are processed through various processes and live sperm cells are separated. These cells are used for IVF treatment. Micro TESE surgery can be performed more than once if necessary.
What are the points to be considered before Micro TESE?
-You should not eat or drink anything for at least 6 hours before the operation (including water). – Clean your genital area and shave it. Take a bath.
What are the possible risks after surgery?
Hemorrhage and hematoma in the scrotum (accumulation of blood in the bag)
– There may be pain after operation, infection may develop.
-Hydrocele (fluid accumulation around the testicle) may develop.
-Decrease in testosterone (male hormone) level may be seen in the 3rd and 6th months after the operation
As a result of this process, there is a risk of not finding any sperm cells.
What are the Considerations After Micro TESE Surgery?
The patient does not need to lie down after the operation, but it is recommended not to do heavy physical activity for 10 days and not to have sexual intercourse. Dressing should be done 48 hours after the operation. Shower can be taken 3 days after Micro TESE surgery. Patients are recommended to use tight underwear for 10-15 days after the operation. There is no need to take stitches as the stitches will melt spontaneously in about a week.