MD-TESE (Microscopic Testicular Sperm Extraction)


Azoospermia, one of the most serious types of male infertility, is best treated with TESE (testicular sperm extraction.) There are methods like traditional medicine to attempt to repair it, but this can take a long time, which you might not have if you and your partner are getting older.

Even if you have already been diagnosed with Azoospermia, even just a few sperm could be found in TESE, and with ICSI a fertilized oocyte could occur.

At our hospital, we are actively working on advanced medical treatment such as MD-TESE (microscopic testicular sperm extraction), and in fact, with these treatments, sperm was found in nearly half of the patients. Even if the sperm-producing function works normally, but the sperm-carrying tube is clogged and does not mix in the semen, or if the sperm-producing function is low, as long as sperm are found in the testes, micro-insemination is possible.

In TESE an incision is made in the scrotum about 0.5 cm to 1.0 cm and a little tissue is collected from the seminiferous tubule. In MD-TESE, the entire testis is observed under a microscope under general anesthesia, so that as many sperms as possible can be collected, which is our usual method.

The seminiferous tubules collected from the testes are selected for good condition with a high probability of sperm, and the embryologist spends hours searching for even one sperm in the tissue. Even if only a few sperm that can be collected, ICSI (intracytoplasmic sperm injection) is performed using the sperm found.

Sometimes sperm can be frozen, but if the numbers are very small, the damage caused by freezing may prevent the sperm from being used next time. At our hospital, we aim to fertilize in good condition by collecting oocytes and doing MD-TESE at the same time. In particular, in the case of non-obstructive azoospermia with high FSH, there is no test to determine whether sperm can be reliably collected before surgery, and it is not possible to actually obtain sperm in TESE, but regardless, checking the testicles to find sperm is an important step in the fertility process if it is needed.

The testicles have an important function of secreting androgens, and people with azoospermia usually have low levels of androgens. Surgery can cause very low levels of hormones. After the operation, it will recover to some extent, but if the testicles on both sides are operated on at the same time, the male hormone will be lost and it may cause physical problems. Therefore, we perform surgery on only one testis.

It is usually a one-day outpatient surgery, but if you are not feeling well or if you wish, you can be hospitalized overnight. We also respond to sudden changes after surgery 24 hours a day.