If you have been experiencing reproductive difficulty that has been traced to a low sperm count, you deserve to know about the most recent, most non-invasive procedures now available to make it possible to harvest sperm and move you further toward the cherished goal of parenthood.
State-of-the-Art Male Infertility Treatment: Micro-TESE
The frustration you have felt in your attempts to achieve a pregnancy does not have to be compounded by treatment that is unduly painful or accompanied by risk. Dr. Philip Werthman, who has achieved world recognition as a male infertility specialist, has worked for years to develop the most precise, least invasive approaches now available. Along the way, he has transformed procedures that used to involve a two-hour operation requiring general anesthetic to services that can be delivered in his office with only local anesthetic.
The current “state of the art” treatment is known as “Micro-TESE,” short for Microsurgical Testicular Sperm Extraction. To fully appreciate the magnitude of this breakthrough, it is helpful to know a bit about what came before it.
Testicular Mapping Process
The testicles are filled with tubules in which sperm are produced. Even in cases where men have no sperm in their ejaculate, it can be possible to find sperm in these tubules.
In the past, this has been attempted through “testicular mapping,” a process that can achieve success, but one that also has some drawbacks. In the first step of this technique, a fine needle is used to draw samples of tubules from various locations on the testicle. This is done methodically, with samples drawn from locations designated on a grid that has been drawn on the testicle.
The samples are placed on slides and examined by a cytologist (an expert in the microscopic appearance of cells), who looks for sperm. A positive finding can be connected to the location on the grid from which the tubules were taken.
However, the number of tubules that can be removed by the fine needle is only enough for the slide. There are not enough to freeze or use with IVF. Thus, a second surgery is required in which the surgeon returns to the area where sperm were found to harvest live sperm.
Despite the use of the grid, the initial step in this procedure is essentially random. It is entirely possible that the patient does in fact have viable sperm in his testicle, and that it will not be found. In fact, most men do produce sperm at some level, so the prospect of having to undergo a procedure just to verify something than can be assumed to be true is somewhat paradoxical.
Moreover, there is the possibility that a blood vessel could be punctured by the needle, leading to internal bleeding or other complications.
Fortunately, there is a better option: Micro-TESE.
How Micro-TESE Works
As you might expect, the tubules in the testicles cannot be examined by the naked eye. However, tubules that produce sperm look different than the ones that don’t and with the aid of a microscope these differences can be clearly detected.
In the Micro-TESE procedure, the surgeon makes a small incision in the testis and uses a microscope to find tubules with an appearance indicating they are likely to contain sperm. This technique removes the guesswork and the extra time associated with the older approach.
Advanced Technique for Male Infertility
As a pioneer in this advanced technique, Dr. Werthman brings an exceptionally refined eye to this process. Once he has located promising tubules, a specimen is taken. The material is placed in a Petri dish that contains sperm wash media and is examined under a microscope. Sperm that are found can be frozen for future use or incubated and injected into eggs.
Micro-TESE offers a number of distinct advantages:
- It has a much higher success rate – The odds that Micro-TESE will find sperm are greater than 60 percent. This is twice the success rate that could be expected through other techniques. If you’re investigating this option, you most likely have had enough disappointments. Here’s a chance to avoid another one.
- It is less invasive – only one procedure is required.
- It is more efficient – You won’t have to wait for slides to be examined, get those results and then wait for the outcome of a second procedure.
It’s important for you to understand that only a handful of surgeons in all the world offer Micro-TESE. While it may be easy to understand the logic of such an approach, its execution it requires a physician of great skill and expertise. For years, Dr. Werthman has set the standard for care that is compassionate, minimally invasive – and, above all, effective. You could find no better companion for your journey to parenthood.