Azoospermia is a severe male factor in infertility, and the occurrence is around 15% in the infertile men. There are two types of azoospermia,—obstructive and non-obstructive.
Meanwhile, we can classify Azoospermia more detail into three major types as listed.
- Non-obstructive
- Hormone deficiency
- Testicular failure
Literally, non-obstructive azoospermia refers to no sperm in the semen because of abnormal sperm production.
The fertility specialist generally recommended these patients to take microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) combined with intracellular single sperm injection (ICSI) in the IVF program.
How to do the MESA/TESE?
Under regional anesthesia, we would cut apart the scrotum and use a surgical microscope to open the small tubes within the epididymis to look for mature sperm or immature sperm cells. The sperm harvested can be used immediately or frozen for use at a later time. If no sperm are found in epididymis, it is necessary to look inside the testicle for viable sperm.
Usually, the number of sperm retrieved is small and poor activity. Therefore, it is very precious. It is best to use intracellular single sperm injection (ICSI) to increase the fertilization rate. The remaining sperm can be frozen for future use.
This is the most effective solution to solve azoospermia retrieving sperm.
Also, with the Vitrification, it can be used several times at a time to achieve maximum benefit.
Through MESA/TESE and ICSI, it helps to increase the fertilization rate by approximately 70%. About the pregnancy rate, it’s the same as normal in vitro fertilization which is 50%-60%.
