Azoospermia (absence of sperm), occurs in 1% of the general population, and in 10-15% of the infertile male population. It may be functional or non-obstructive (NOA) or Obstructive (OA)
The management of non-obstructive azoospermia (NOA) depends on finding sperm in the testes and retrieving the sperm surgically so it can be used in IVF treatment. This because men with NOA may have patchy areas inside the testes where there is some sperm production that is not enough to appear in the ejaculate.
At CRGH we offer the best and most advanced technique of finding sperm in men with NOA, that is micro-dissection testicular sperm extraction (Micro-TESE) which is superior to any other technique in men with NOA. This technique uses state of the art surgical microscope and under high magnification an experienced microsurgeon will identify the areas that are most likely to contain sperm and selectively take tiny pieces from these areas for the embryologist to confirm the presence or absence of sperm.
Micro-TESE requires an experienced microsurgeon, an expensive microscope, and theatre time as it may take the surgeon up to 2 hours to find sperm.
Some of the causes of obstructive azoospermia (OA) can be treated by microsurgical procedures (epididymo-vasostomy in epididymal blockage and vaso-vasostomy in blockage of the vas deferens). These procedures are aimed at reconnecting the seminal ducts and bypassing the blockage. In cases of ejaculatory duct obstruction (EDO) transurethral resection of the ejaculatory ducts (TURED) is performed to resect the blockage.
If this is not indicated or fails, surgical sperm retrieval is offered and the sperm is extracted for use in IVF-ICSI treatment.
Several techniques may be used depending on the site of obstruction such as percutaneous epididymal sperm aspiration (PESA), Microepididymal sperm aspiration (MESA), testicular sperm aspiration (TESA) and window testis biopsy.
Sperm retrieval in OA is easier than NOA because sperm production is normal.
Our consultants are experienced microsurgeons with special interest in male infertility. Their skill and advanced techniques offer males with azoospermia the best chances of fathering their own child.
If you would like to book an appointment with one of our doctors you can: