RCC has a urologist with specialized training in the investigation and treatment of male factor infertility. Your physician may recommend a consultation with the urologist for further evaluation. Some patients require specifics treatments as part of their IVF cycle.
MESA (microsurgical epididymal sperm aspiration)
With this method, fluid that contains sperm is collected from the small tubes of the epididymis in the testicle, through a small incision. Several areas of the epididymis may need to be sampled, but the testicle is not entered. This technique usually collects enough sperm to use and freeze for future use.
Sperm retrieved using this technique must be injected into the egg by ICSI (intracytoplasmic sperm injection) techniques as part of the IVF process.
PESA (percutaneous epididymal sperm aspiration)
With this technique, a small needle is inserted through the skin of the scrotum to collect sperm from the epididymis. Fewer sperm are usually collected with PESA than with the MESA technique but the procedure is easier and faster than with MESA. Sperm retrieved using this technique must be injected into the egg by ICSI (intracytoplasmic sperm injection) techniques.
TESA (testicular sperm aspiration)
With this technique, a needle is used to take a small amount of tissue (a biopsy) from the actual testicle itself. This technique usually does not retrieve enough sperm to freeze and store for later use but it is a method that can be used to obtain sperm when all other methods do not work. Sperm retrieved using this technique must be injected into the egg by ICSI (intracytoplasmic sperm injection) techniques.
Vasectomy reversal represents major surgery of the scrotum. This procedure reattaches the two ends of the epididymis that were previously divided to prevent sperm from being in the ejaculate. Most patients with vasectomies develop sperm antibodies that may hinder fertilization of the egg during the IVF process, even if the reversal procedure is surgically successful. Some vasectomy reversals are not successful long-term (the reversal area closes over again). A urologist can do a vasectomy reversal.