If no sperm can be found in the ejaculate in a spermiogram that is completed twice (which in technical language is referred to as “azoospermia”), then to fulfil the desire to have children, an attempt can be made to obtain mobile sperm from testicular tissue.
Sometimes, no sperm can be found in the ejaculate of the man (azoospermia). If this finding is confirmed, there is the option of taking a biopsy from the testis through a small operation. We then examine this biopsy in the centre for the presence of vital sperm.
If sperm can be found in the testicular tissue, then the testicular tissue is deep-frozen (cryopreservation) in several portions, in order to store samples for several attempts. This procedure is then followed by artificial insemination in the form of an ICSI treatment.
The treatment frequently allows men who have made the conscious decision to be sterilised to become fathers when they again desire to have children.
Therefore, TESE treatment is also recommended in the case of
- sterilisation of the man
Before the start of TESE, genetic counselling and chromosome analysis is recommended for both partners. The chromosome analysis is completed on the basis of a blood sample and is carried out by a human geneticist. The results will be available after about four weeks.
The TESE procedure
TESE is a simple procedure that is carried out by a urologist on an outpatient basis. In this, under a brief anaesthetic, two to three piece of tissue the size of a pinhead are removed from each testicle. Because the pieces of tissue that are taken are very small, the risk of a subsequent impairment is rather low. Afterwards, you can expect to be unfit for work for about one week.
In the Fertility Centre, we prepare the tissue samples from the testicles on the same day as the operation and examine these under a microscope for the presence of mobile sperm. If sperm can be found, then all tissue samples that were removed are deep-frozen (cryopreservation) and are now available for fertility treatment. Therefore, the patient finds out on the same day whether the TESE operation was successful. The testicular samples are stored directly on site in our Fertility Centre, so that the subsequent fertility treatment (ICSI) can begin promptly.
On the day of ovum collection, one of the deep-frozen testicular samples is thawed in the laboratory. An attempt is made to select exactly the same number of sperm from the piece of tissue as there are ovum cells being removed. Any testicular samples that are not used remain deep-frozen and are available for later fertility treatments.
In the case of azoospermia, if no sperm are found in the testicular tissue, then there is unfortunately no hope for the man of having a child that is genetically his. In our fertility centre we can offer these couples insemination with donated sperm (donor insemination).
If sperm are found in the testicular sample and the ova can be successfully fertilised, then the success rate of an ICSI treatment following TESE corresponds to that of a conventional IVF/ICSI treatment. Thus, the success rates per treatment cycle are about 20 to 30 percent.
Most health insurance companies contribute to operative procedures for obtaining sperm cells.
The preparation, freezing (cryopreservation), and storage costs must be borne by the patients themselves.
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