Fine-needle aspiration in vitro fertilisation and ovum micro-fertilisation with testicular sperm extraction (FNA or TESE)
In cases where there are no spermatozoa produced during ejaculation (azoospermia), there is the possibility of attempting to collect spermatozoa from the testicles, which is where they are produced. In some cases the absence of spermatozoa during ejaculation is due to the fact that the tubes carrying the spermatozoa outwards are congenitally absent, as is the case with men who are cystic fibrosis carriers, or have been obstructed due to chronic inflammation or prior ligation of the seminal ducts as a means of contraception. In such cases there are numerous spermatozoa in the testicles which are not carried through and local anaesthesia allows us to preform biopsy of the testicles with a fine aspiration needle (FNA) so as to draw their content, which usually includes a satisfactory number of spermatozoa. A second case of azoospermia is caused by production failure, when there are very few spermatozoa in the testicles and there is no way to detect their exact location. For that reason - under full anaesthesia - microbiopsies are performed to on the testicle (TESE), after a small incision is made in the scrotum and samples are taken from different parts in search of spermatozoa. If none are found in one testicle, we repeat the process with the other. In case of non-obstructive azoospermia the chances of finding spermatozoa in these biopsies is approximately 50%. Subsequently, the spermatozoa that have been collected either with fine needle aspiration or microbiopsy are analysed in the laboratory, and the ones to be introduced to the ova with microfertilisation for fertilisation to take place are isolated. The sameprocessdescribedaboveisimplemented.