All success of IVF, regardless of the technology being used, will depend on the woman’s age. If there is sperm to work with, whether it’s coming from the testicle, from the epididymis or from the ejaculate, it all depends on the woman’s age. So a woman who is 28 will have super results regardless, provided that egg reserve is fine, a woman who is 43 contrary to what people say, unfortunately her expectation has to be modest and 10% will not be an unreasonable expectation.
The chance of success after a TESA procedure will be pretty much the same as the chance of success in your clinic using ICSI with ejaculated sperm – that’s what the studies show so far. Some people think there’s a theoretical benefit to doing these because you’ve got less DNA fragmentation but I’m not sure it’s ever been backed up with the studies. So in essence, all you’re looking for is sperm for ICSI – it should have the same outcome pretty much depending on the underlying problem whether it’s from the testicle itself, from the epididymis or from the ejaculate.
Sperm retrieval success rate by using TESA depends on whether azoospermia is obstructive or non-obstructive. In men with obstructive azoospermia, the sperm retrieval rate is close to 100%, while in men with the non-obstructive condition it is only 15 to 50%. It is also important to understand that pregnancy and birth success rates are highly dependent on female factors such as age, FSH level, BMI, and antral follicle count.
The success rate of TESA depends on the indication. It is not the same if we are going to do TESA in a patient who has had a vasectomy, for example, which obviously means that he’s going to be a fertility proven patient than if we are going to aspirate or obtain sperm in a patient with a severe oligozoospermia, with a low volume testicles.
In these cases, on top of having difficulties obtaining the sperm, it may also happen that this sperm may carry genetic issues. The medical background is very important, and this is something that should be discussed with the andrologist and the patients to see the chances of first obtaining sperm and second, that this sperm may help create a healthy embryo.
