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TESE and MESA

Hope for Men Battling Infertility

By C.J. Johnson

MESA may also be the better choice for couples who want more than one child.

However, there are circumstances that make TESE a more reliable procedure. According to Dr. Robert E. Brannigan, head of the Division of Male Reproductive Medicine and Surgery at Northwestern University Medical School, a man's fertility problem should be carefully considered before deciding which procedure to use. "They should consider the male's underlying problem," he says. "Does he have a blockage, or is the issue an abnormality in sperm production? The urologist is often able to successfully predict ahead of time which of these two problems is at hand based on the patient's history, physical exam and laboratory test results."

There are times, however, when the underlying problem is not clearly defined. "Generally, we start with a very small testicular biopsy with TESE in these cases," Dr. Brannigan says. "If it is clear that a blockage is present, then we'll proceed with MESA."

TESE and MESA combined with intracytoplasmic sperm injection (ICSI) create great chances of conceiving. With ICSI, fine instruments select a single sperm cell and inject it into an egg to complete fertilization. Combining TESE with ICSI is usually considered more effective than a vasectomy reversal and takes less time than waiting to conceive naturally.

Brannigan explains the simplicity of ICSI. "Our embryologists now have so much experience using testicular sperm, that it is not viewed as being a significant issue or problem in most cases," he says. "The important point is finding viable sperm. If we can do this for the embryologist, their part of the case tends to be straightforward."

In-vitro Fertilization
Although both TESE and MESA are effective, and an adequate amount of sperm is extracted with both procedures, neither one is enough to use with artificial insemination

Want to see more?

• A Good Egg or Sperm
• Fertility and Disabilities
• Male Factor Infertility
• Antisperm Antibodies: The Myths, the Truths and the Treatments of Sperm Allergies
• Eight Ways to Help Improve Male Fertility
• Talk about it!