For the special technique in the case of male infertility, there is the method called “testicular sperm extraction” (TESE).
This is the method of taking the sperm directly from the tissue of the testis in azoospermia when sperm cannot be found in the ejaculated semen. Anesthesia will be used and a very small incision will be made and the tissue will be collected. This is a very simple procedure which can be completed in little time, and at our clinic, we are in alliance with the doctor of urology and we will perform it arranged to the OPU day.
When the cut open testicle is looked at with a magnifying glass, the places where there is sperm will appear as white. The method used to take tissue while looking through the magnifying glass is called, “Micro TESE”. Since we can choose the portion where there seems to be sperm, it is less invasive to the testicles and it has a high success rate. At our clinic, all cases will undergo Micro TESE.
The presence of sperm in the collected tissue will be checked for underneath the microscope and the sperm will be recovered and used for microinsemination or will undergo cryopreservation.
In addition, a portion of the tissue will be used for pathology testing. The tissue will be dyed and depending on the observation, we will know about the internal structure of the testicles. We will check for things such as the presence of sperm and cells that will be the origin of sperm, the developmental stage, and the cells that send nutrients to the sperm (sertoli cell), and then undergo the evaluation by means of Jonsen’s Score Count.
|Jonsen’s Score Count
TESE Classification Results
|10||Complete spermogenesis and the sperm cell layer are thickly and properly arranged and in the lumen there acknowledged to have a many number of sperm.|
|9||There is an acknowledged numerous sperm, the sperm cell array is irregular and the lumen is narrow.|
|8||There is around 5~10 sperm found in the seminiferous tubule.|
|7||Sperm is not found, and a number of sperm cells are found.|
|6||Sperm is not found, and about 5~10 sperm cells are present.|
|5||Sperm, sperm cells are not found, and a number of spermatocytes are found.|
|4||Sperm, sperm cells are not found, and some spermatocytes found.|
|3||Only spermatogonia are found.|
|2||Sperm cells are not found, only sertoli cells are found.|
|1||Only fiber components and no cellular tissue.|
At our clinic, we will culture a portion of the tissue retrieved by TESE, and we will try to attempt to induce the sperm in vitro.