and they continue to decline by more than 1% per year.
my wife’s clock is ticking
FACT
Men also have a biological clock.
Men over 40 have lower sperm counts and lower sperm quality. Over the past 40 years, men in Westernized countries have seen sperm counts drop by more than
50%
MYTH
Micro-TESE
Micro-Testicular Sperm Extraction (mTESE) involves an operation under general anaesthetic performed through a small incision in the scrotum, through which the inside of one or both testicles can be examined under a microscope with the intention of harvesting sperm for use during in vitro fertilisation (IVF).
Who should consider micro-TESE?
Micro-TESE is recommended for men who have abnormal sperm production (non-obstructive azoospermia). There are many causes of this including previous testicular surgery, previous medical treatment, a genetic problem, and other male factor infertility issues. Your fertility specialist or urologist will have organised tests to investigate this before surgery. You should have seen a fertility specialist together with your partner with a view to IVF.
the benefits of micro-TESE
5050
Sperm is found using micro-TESE in only about one in two (50%) of cases. However, many studies have shown that micro-TESE yields the highest sperm retrieval rate and importantly, causes the least amount of damage to the testicles.
What are the risks?
Risks of this surgery include testicular and scrotal discomfort and pain, bleeding and infection. There have been reports of temporary low testosterone levels after the procedure. This usually recovers spontaneously without any symptoms. There have been very rare reports of severe testicular damage, and also rare reports of chronic testicular pain. There is a high chance that we may not find sperm.
What happens during the procedure?
Under anaesthesia, a small incision is made down the middle of the scrotum, and the testicle exposed. The surgeon examines the inside of the testicle under a high-power operating microscope, looking for seminiferous tubules (where sperm is produced and transported) and searches for swollen tubules which are more likely to contain sperm. The sample tissue is then passed to a specialist embryologist from the fertility clinic, who will look for the presence of sperm. The surgeon will continue looking until they find sperm, or until they have examined and biopsied the testicle without seeing any sperm. The testis and scrotum are closed with fine dissolvable sutures (stitches).
If sperm are found during micro-TESE, they are extracted and can be frozen for future reproductive treatment, such as in-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Sometimes the mTESE procedure is scheduled to coincide with the female’s ovulation, to enable the use of fresh unfrozen spermatozoa. The whole operation usually takes around two hours. In most cases after the procedure, you will be contacted by the embryology team at the Fertility clinic within a few days to confirm the presence or absence of sperm from the harvest.
what to do next
Check out the FAQ for what you can expect before and immediately after surgery. Also, what not to do when you get home.