Sperm can be
aspirated with a needle from the testicle or from the vas deferens (a structure
right next to the testicle that also contains sperm). The man is given some
drugs to sedate him and some local anesthesia is also used to numb the area.
Then a small needle is inserted and sperm is aspirated from either the
epididymis or the testicle. There should be no severe pain. The procedure
generally takes about 30 minutes. The different sperm aspiration and extraction
procedures have long names and also short names (acronyms):
·
TESA
- Testicular Sperm Aspiration (can be done in the office)
·
TESE
- Testicular Sperm Extraction (involves a small incision and snipping off some
tissue from inside the testicle - often done in a hospital or free-standing surgicenter).
Sperm
extraction is being performed more and more by non-urologists (called
andrologists) who are actually either internists or obstetrician-gynecologists.
It stands to reason that these non-urologists prefer TESA, given that they are
not surgically trained. There has always been debate, however, as to which
procedure is “better” at obtaining sperm for successful intracytoplasmic sperm
injection.
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