For many couples, trouble becoming pregnant does not rest solely on the woman. Testicular Sperm Aspiration, known as TESA for short, is a procedure to recover sperm from the male’s reproductive organs in an effort to ensure pregnancy through in vitro fertilization, or IVF. One of the most common reasons for undergoing TESA is a condition known as azoospermia – which indicates there is no sperm found within the semen.
Zero sperm in the semen is only detected by observing it under a microscope – there are no outward signs of the condition, and most men have a very normal libido and sexual function. Due to the low number of sperm collected through the procedure, it must be done in conjunction with IVF and intracytoplasmic sperm injection, or ICSI.
During the outpatient procedure, the patient undergoes TESA in the doctor’s office in a short amount of time. A local anesthesia is administered to the testicles and a small, thin needle is inserted into the testicle to extract a sperm sample. Once the sample is removed, it is observed under a microscope to determine which samples are best for implanting directly into the egg through ICSI. Through ICSI, the sperm is collected in a small, hallow needle and inserted into the egg for fertilization.
Once the sperm and egg are joined, it spends three to five days fertilizing in a Petri dish before being inserted onto the uterus. After the fertilized embryo is placed in the uterus, patients may wait up to two weeks to take a pregnancy test to confirm a pregnancy.
In most cases, sperm retrieval takes place the same day the female partner undergoes an egg retrieval – that way the sperm immediately begins to fertilize the egg to develop into an embryo. With TESA, there are success rates that range between 30 to 70 percent – and up to 45 percent of men with zero sperm initially have the presence of live sperm in the retrieved sample.
Who’s a Candidate for TESA?
There are a few conditions which may cause the sperm count to be zero. Ideal candidates for the procedure include:
Benefits of TESA
Before this type of procedure was available, men with zero sperm in their semen had to undergo a surgical procedure to extract sperm – and the procedure required a hospital stay and recuperation period. TESA is a quick procedure, only requires local anesthesia and is substantially less money than the surgical alternative.
Cost of TESA
The cost of testicular sperm aspiration varies in costs depending on location. Costs fall between $6 and $16,000 USD and in some cases, medical insurance covers the procedure if it is done with other treatments. When undergoing the procedure in conjunction with IVF, costs for the overall cycle increase. Outside of the United States, total costs are often one-third less for TESA and an IVF cycle.
Finding Fertility Doctors and Specialists
Obstetricians and gynecologists are trained to implement the initial treatments of infertility using Clomid. Such a physician or fertility specialist should be board certified in reproductive endocrinology and infertility. Couples should find specialists who are a member of endocrinologist organizations or technologies. As such, they have completed medical school programs, followed by four years of residency training in obstetrics and gynecology, and then, two to three years of training in fertility within an approved program that results in board certification.
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