Surgical sperm recovery and ICSI is necessary for patients presenting with infertility due to obstructive or non-obstructive azoospermia.

PESA (Percutanous Epididymal Sperm Aspiration)

The simplicity of the technique means that it can be performed under local anaesthetic or mild sedation as an outpatient procedure.The epididymis is palpated and punctured with a fine needle through the skin.

TESE ( Testicular Epididymal Sperm Extraction)

The surgeon exposes a small area of the testis by making a cut in the scrotum and the underlying tunica vaginalis.Gentle squeezing of the tissue cut with a scissors.

TESA (Testicular Sperm Aspiration)

A wide bore needle is pushed into the testis through the skin. Suction is applied and the needle withdrawn

MESA ( Microsurgical Epididymal Sperm Aspiration

The need for a clean preparation restricted retrieval to MESA,carried out by skilled micro-surgeons in an operating theatre environment.The men would normally be under a general anaesthetic or spinal block .This technique involves exposure of the epididymal tubules by opening the scrotum and the tunica vaginalis.

" In Thailand, the first sucessful TESE / ICSI was reported by Pol.Lt.Gen.Jongjate Aojanepong, M.D. in March 1996. The babies were healthy twins. "

References

1. Fleming S. การเก็บอสุจิโดยการผ่าตัด.  ใน :ธีระพร วุฒยวนิช,บรรณาธิการ.เทคโนโลยีช่วยการเจริญพันธุ์.  2546; หน้า 127-36

2. Tournaye H.Epididymal and testicular sperm extraction :clinical aspects.Texbook of Assisted Reproductive Techniques: ; 585-88

3. Stewart B.Surgical sperm recovery.Textbook of Assisted Reproduction for Scientists in Reproductive Technology:1968 ;155-62