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Microdissection TESE

What is microdissection testicular sperm extraction (micro-TESE), and why choose to have it?

Microdissection testicular sperm extraction (micro-TESE) is the microsurgical technique utilized to search methodically through the seminiferous tubules of each testis using the surgical microscope to identify and obtain sperm (if present) from the testes of men without sperm in the ejaculate (called non-obstructive azoospermia).  If sperm are identified (as few as just several sperm could be adequate), these may be used for fertilization using in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).  Micro-TESE is the optimal technique for sperm retrieval which results in the least scarring to the testicle is microdissection testicular sperm extraction (micro-TESE).  

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Who are candidates for sperm extraction with micro-TESE?

For men who have no sperm in the ejaculate (non-obstructive azoospermia), there are several sperm retrieval techniques that can be used all of which involve obtaining sperm either with a small scrotal and testicular incision (testicular sperm extraction, TESE) or needle placed into the testicle (testicular sperm aspiration, TESA; Fine Needle Aspiration, FNA mapping).  As described, micro-TESE produces optimal outcomes with least scarring of the testis.

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What are the predictive factors for micro-TESE?

Men who are older or have smaller testes, higher FSH, or higher BMI levels are do not have worse sperm retrieval rates with microTESE.  Micro-TESE is successful post-chemotherapy as well with varying rates depending on the type of chemotherapy regimen.  However, male BMI is a predictor of successful pregnancy.

Source :- https://www.malereproduction.org/microdissection-testicular-sperm-extraction/

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