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| Surgical testicular
sperm extraction - the painless technique |
| The
best treatment choice for the man with azoospermia ( zero
sperm count) is testicular sperm extraction ( TESE) with
ICSI ( intracytoplasmic sperm injection) in which testicular
sperm are injected into the eggs in order to fertilise
them. Here is a photo-essay which describes the painless
technique we use in our clinic for extracting testicular
sperm in azoospermic men when they need TESA-ICSI ( testicular
sperm aspiration with intracytoplasmic sperm injection.)
This method was developed
by our andrologist, Dr Rupin Shah. We call it the "
Dr Shah Needle TESA technique."
Most men are understandably scared
of allowing a surgeon near their testes - and even a
testis biopsy can be a very painful experience. This
revolutionary technique allows us to extract testicular
sperm, even from men with tiny testes, without having
to make a skin incision !
Not only is this much easier for the
patient, it also much less traumatic, which means it
can be repeated if needed. It is usually done under
local anesthesia. We can sample multiple areas ( needle
mcirobiopsies) of the testes with this method.
If you would like to see a closeup,
please click on the thumbnail of the image of interest.
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1. The testis
is stabilised by stretching the skin tightly
over it. |
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2.
A "butterfly" needle is inserted
into the testes through the taut skin. Negative
pressure is applied using a 10 ml syringe. |
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3.
Multiple passes are made into the testes with
the needle, allowing us to apply significant
negative pressure to "suck" out
the testicular tubules. |
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4.
The needle is withdrawn, and a strand of testicular
tissue follows the needle on its way out.
This is pulled out gradually from the testis. |
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5.
The strand of testicular tissue is grasped
with a fine forceps. |
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6.
This strand is pulled out gradually. |
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7.
The tissue is then collected in culture medium.
We can get a surprisingly large chunk, with
not a drop of blood, in a few seconds. |
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8.
This tissue is then examined under the stereozoom
microscope in the IVF lab, and the tissue
processed and analysed for the presence of
testicular sperm. |
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