So the sperm retrieval from the testicles can take depending on how easy it is for the doctor to reach the level or in the testicle that needs to remove the sperm from. If it’s reachable, if the testicles are healthy, the process shouldn’t take more than 20 minutes or half an hour from the start to the end and the patient will be under sedation and therefore, the whole procedure depending on how quickly we can find the sperm. So specimens are removed from the testicles passed on to the lab where an embryologist under the microscope looks at it. If they find a good amount of sperm from what is retrieved, from the testicles, then we can quickly process those in the lab and stop the procedure as fast as possible.
TESA is a technique where we puncture the testicles in order to retrieve, aspirate testicular spermatozoa directly from the testicles and it is a very good technique for obstructive azoospermia when we are confident that there are lots of spermatozoa and active spermentogenesis in the testicles and while it doesn’t seem to work well for non-obstructive azoospermia when well, we really don’t know what level of spermatogenesis exists in the testicles. So for obstructive azoospermia cases, we can result in TESA and as this is a puncture, it normally takes a very short time. It will need a mild anesthesia in order to avoid any discomfort for the patient and then one or two or a little bit more of puncture will follow until enough spermatozoa, testicle spermatoza are retrieved and normally these spermatozoa will be used this very same time a day for fertilization, for micromanipulation and fertilization and that’s why normally TESA is scheduled on the same day of egg retrieval. The main limitation of TESA is that the number of the testicular spermatozoa retrieved is small, so that’s why we tend to use it for fresh procedures rather than cryopreservation.
Depends on the kind of operation that you’re having done. There’s quick and easy procedures like a TESA which might take about half an hour, a PESA that might take some length of time perhaps a little bit longer (you need to do an open biopsy) perhaps 45 minutes or so and you go through for a MESA it might take an hour during the anesthetic time, up to a micro TESE which could take up to about two to three hours they’re much more longer, more involved. It kind of depends on what the nature of the problem is, the type of procedure that’s selected and what’s going to be involved in it.
When we’re talking about sperm retrieval we can be talking about different techniques. We have the PESA which is the percutaneous sperm aspiration so when we aspirate with the needle sperm from the epididymis of one of the testicles or of both of the testicles; it’s the TESA which is again the testicular the aspiration of sperm from the testicle itself or the testes and also we have the known TESE or a micro-TESE that we see more frequently these days being followed as a procedure in the clinics.
It depends on the type – it can take different times, for example, for just an aspiration – the aspiration is a quick technique, sometimes some clinicians do a local anesthetic and within 15 minutes the procedure is done. When we are talking about TESE or a micro -TESE, the time can be dependent on whether the TESE is bilateral so if it has been done the biopsy is being taken from both testicles or only from one testicle. It also depends on how challenging would be for the urologist and the andrologist or embryologist being in theaters as well, how challenging it is to find for the urologist and to extract the tissue and how challenging it is for the scientists in the lab to find sperm and also as I said if it is bilateral, for example, it can take slightly more than an hour, if it’s based on one testicle it can be approximately an hour to 45 minutes but again the times can be different and varied depending on how healthy the testicular environment is and what type of procedure for what type of procedure for sperm retrieval is being followed
