Sperm Retrieval for Obstructive Azoospermia

At Yale Urology, we have a world class, state of the art center for treatment of azoospermia (no sperm in the ejaculate).

Dr. Honig will review your case and determine the best approach. 

There are two groups of patients that may be candidates for sperm retrieval: those with obstructive and those without obstruction (ie, a problem with sperm production).

These problems are treated differently. In most cases, a history, physical examination and blood work can determine whether your case is obstructive or non-obstructive. 

Cases of obstruction usually are a result of prior vasectomy, absence of the vas deferens, or a blockage at the epididymis, a hernia repair site, or at the ejaculatory duct. These cases can be treated with either reconstructive surgery or sperm retrieval. In nearly all obstructive cases, sperm can be retrieved from either the testis using a procedure called testis sperm aspiration or extraction (TESE) or from the epididymis using microsurgical epididymal sperm aspiration (MESA).

In most cases,Dr. Honig performs these procedures as an office procedure under local anesthesia alone. In certain cases, sedation may be offered if the  anatomy is unusual or if the patient prefers.

With one MESA sperm can usually be obtained for multiple cycles of IVF.  This limits the cost and discomfort.  In a small number of cases, if epididymal sperm quality is borderline, Dr. Honig will perform TESE at the same time.  In most cases, the procedure can be performed prior to starting an IVF cycle. This allows confirmation of good sperm quality prior to incurring the costs of an IVF cycle.  After the procedure, patients may require some pain medication and will require a few days off from work.

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