Patients with Non Obstructive Azoospermia (NOA), were once considered infertile with very few treatment options due to the absence of sperm in the ejaculated semen. As reproductive science advanced, there came in ICSI (Intra Cytoplasmic Sperm Injection) and various applications of sperm retrieval techniques including Micro TESE.
The procedure is of great help when the sperm map reveals only one to two hot sperms showing in semen. This procedure requires microsurgical expertise. Testicular extraction of sperm is done under high power magnification. Usually done under regional or general anaesthesia. A scrotal incision is made and the testis is delivered through the wound. It is then bivalved and the search for sperm containing tubules is done under the operating microscope. The figure below shows the testis being bivalved and the enalrged tubule being identified under the microscope. This tubule would be picked up and sent to the lab which would be screened by the embryologist for the presence of sperm.
At the Metromale clinic, Dr.Karthik Gunasekaran, being a Microsurgeon and an Embryologist does the screening himself. This way the inter-observer variability is negated and results are higher than average and satisfactory.