TESE and TESA procedures are surgical methods recommended for men who do not have viable sperm cells in their semen. The absence of viable sperm in the semen is also called azoospermia. It is known that conditions such as some genetic disorders, febrile diseases at a young age, hormonal disorders and receiving chemotherapy treatment cause azoospermia.
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The absence of sperm in a man's semen can be due to various reasons. Some of these are due to obstruction of the sperm ducts. In such a case, there is no sperm production in the testicles. However, existing sperm cannot be ejected with semen due to obstruction in the ducts. In this case, it is said that there is no sperm due to obstruction (obstructive azoospermia). In cases of azoospermia due to obstruction, small pieces are taken by entering the clogged channels or testicular tissue with a fine needle. The rate of finding sperm in these parts is close to 100%. During the TESA procedure, local anesthesia is applied to our patients to prevent them from feeling pain.
If it is determined that there is no obstruction as a result of the TESA procedure, there is either no sperm production in the testicles or there is a limited number of them in certain areas. In such cases, a similar surgical method, TESE, is recommended for our patient.
TESE means obtaining sperm from the testis by biopsy. Small sections are taken from different parts of the testes. The testicular tissue obtained is examined under the microscope in the laboratory. In some azoospermia patients, sperm production takes place only in a very small area of the testes. With the TESE method, the aim is to detect these regions. Micro TESE method, on the other hand, minimizes the damage to the facilities. A microscope is used during the surgical procedure. Sperm producing channels can be seen clearly by magnifying with the help of a microscope. Sperm producing ducts are easily distinguished as they appear wider. These areas are determined and collected by the surgeon. Thus, the rate of finding sperm increases many times over compared to the TESE method. Micro-tese surgery can take up to 2 hours as it requires the examination of individual channels. Due to the length of the operation, general anesthesia is preferred over local anesthesia. After the operation, the patient is discharged.
Patients diagnosed with azoospermia can only have children by undergoing IVF treatment. Pregnancy rates are quite high in patients who are found to have sperm production as a result of the TESE operation, especially if the spouse is young and there is no problem. For this operation, patients can apply to their own urology doctors or IVF centers. Urologists can perform this operation diagnostically in any hospital or authorized clinic, but it is much more logical to perform the procedure in an IVF center; Because if sperm cells are found, the embryology laboratory can quickly freeze them, so these frozen cells can be used in the IVF treatment process at a later time.
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