Qiu and colleagues review the technical details of their technique in the only publications describing the PVSA procedure 18 , Back to Top Olive Fertility: The mini-micro-epididymal sperm aspiration for sperm retrieval: A small hydrocele with local anesthesia is left to bathe the testicle and epididymis as the vaginalis is closed. Conventional testicular sperm extraction combined with the microdissection technique in nonobstructive azoospermic patients: Craft I, Shrivastav P.
Successful fertility treatment for Klinefelter's syndrome. From the limited data available, it is suggested that the sperm retrieval technique itself has no impact on ICSI success rates in NOA MESA Microsurgical Epididymal Sperm Aspiration MESA is used in conditions like obstructive azoospermia, involves dissection of the epididymis under the operating microscope and incision of a single tubule. The other fingers of the non-dominant hand can cup and support the testicle. The surgical technique involves the exteriorization of the testis through a cm transverse scrotal incision. The conventional MESA is not usually performed in the office but rather in the operating room under general anesthesia. Fresh sperm is preferable for ICSI because frozen-thawed surgically-retrieved sperm from NOA men have significantly impaired reproductive potential 50,
What Is MESA Sperm Retrieval? - London Urology Associates
We also like to assess the firmness of the epididymis. Longer convalescence than percutaneous approaches. Lidocaine has a quick onset and relatively short duration, while bupivacaine has a slightly slower onset and is longer-acting. Some men on testosterone therapy use a transdermal preparation and will not even disclose that on their medication list. Epididymal micropuncture with in vitro fertilization and oocyte micromanipulation for the treatment of unreconstructable obstructive azoospermia.
Because the MIESA technique identified a transition point on one side, the patient subsequently underwent bilateral epididymovasostomy with successful return of motile sperm to the ejaculate. With the incredible advances in in vitro fertilization IVF , combined with innovative surgical treatment for male factor infertility in recent years, OA is no longer a barrier for men to become biologic fathers. It works by directly stimulating the testicles in order to make more of their own testosterone. This is performed under local anesthetic through a small cm cut in the scrotum. These authors generally prefer to have an anesthesiologist present for MAC to administer a continuous propofol infusion with intermittent dosing of fentanyl. Dissection of one or both testes may be required. The tissue is placed in culture media, and exhaustively examined to find sperm that can be used for ICSI.