MESA and TESE Procedures in IVF

How MESA and TESE Work

MESA involves collecting sperm from the epididymis, a small tube where sperm matures after being produced in  the testicles. This approach is often used for men with a blockage or an absence of the vas deferens, the tube that  normally carries sperm. The procedure is performed under a microscope for precision and care. (Source: Hopkins Medicine) 

TESE, on the other hand, extracts sperm directly from the testicular tissue. This method is used when sperm can't  be found in the epididymis, which is often the case when sperm production is extremely low or when there’s no  sperm in the semen at all. In this procedure, a small tissue sample is taken from the testicle to search for viable  sperm cells. (Source: NIH)  

Who Might Need These Procedures?

Both MESA and TESE are options for men with specific infertility challenges, such as: 

• Blocked or missing vas deferens 

• Prior vasectomy that cannot be reversed 

• Low or absent sperm count in the semen (azoospermia) 

• Genetic conditions that affect sperm production 

These procedures provide the opportunity for couples to use the male partner’s sperm for IVF instead of relying  on donor sperm. 

The Procedure and Recovery

MESA and TESE are outpatient procedures, meaning patients can go home the same day. Local or general  anesthesia is used to ensure comfort. For MESA, a fine needle is used to extract sperm, while TESE requires a small  incision to collect testicular tissue. Most men experience mild discomfort afterward, which can be managed with  over-the-counter pain relief. 

After the procedure, the sperm is either used immediately for fertilization or frozen for future use. Since only a  small amount of sperm is needed for ICSI (Intracytoplasmic Sperm Injection), even a few viable sperm cells can be  sufficient. 

Success Rates and Considerations

The success of MESA and TESE depends on individual factors like the cause of infertility and the quality of the  retrieved sperm. If sperm is successfully collected, it’s then used in the IVF process, often through ICSI. This  technique involves injecting a single sperm directly into an egg, which increases the chances of fertilization. (Source: Oxford Academic)  

It’s important to know that while MESA and TESE offer a path to biological fatherhood, success rates can vary. In  cases where no viable sperm is found, couples may need to consider other options, like using donor sperm. 

Final Thoughts

MESA and TESE procedures have provided hope to many couples facing male infertility. By retrieving sperm  directly from the reproductive system, these techniques make it possible for men with certain fertility challenges  to still have a biological connection to their child. Since every couple’s situation is different, consulting with a  fertility specialist can help determine the best way forward. 

Sources:  

Hopkins Medicine - HopkinsMedicine.org/health/treatment-tests-and-therapies/sperm-retrieval-procedures NIH - Pmc.ncbi.nlm.nih.gov/articles/PMC3739111/ 

Oxford Academic - Academic.oup.com/humrep/article/30/4/