Dr Richa Sharma
Male factor is showing a rising trend these days and it can be multifactorial in origin ranging from Life style changes like smoking,alcohol intake,stress, genetic origin and in majority of cases cause not known which adds to the stress of couples further as when we know the reason we are pacified, problems arise when the underlying causative factor cannot be detected.
Till now male factor was more of considered to be undiagnosed and untreatable and also due to social inhibitions and mind set of people, male infertility was labeled to be as not treatable. With latest advances in the assisted reproductive techniques, solution has been found in such cases( depending upon the clinical scenario) so even males with no sperms can father like others.
Male factor infertility exists when there is failure to conceive, and, a persistently abnormal semen analysis and/or findings on exam associated with male factor infertility.
* In 20% of couples, an isolated male factor is present.
* In 40% of couples, both male and female factors are present.
Thus, in 60% of infertile couples, a male factor is at least partially responsible.
Normal male reproductive function requires adequate semen production and transport, delivery of sperm to the ovum, and, successful penetration of the ovum by the sperm. Abnormalities of any of these processes can lead to male factor infertility
What is Azoospermia?
Azoospermia: means no sperms in the semen. It can be due to some obstruction (Obstructive azzospermia) or can be Non Obstructive Azoospermia depending upon the etiology.
What is MicroTESE?
MicroTESE is a new technique allowing targeted removal sperm(male gametes-shukranoo) forming tissue in males with nil sperms in semen analysis. Traditional methods of searching for Sperms (testicular biopsy, FNAC,TESE,TESA)have a poor success rates of finding sperms.
MicroTESE is done under general anaesthesia,under microscope such that the operative field is magnified by 25 times to search for the much precious sperms. It’s a milestone rather a miracle, a boon for male factor.
Can take over 3-4 hours of painstaking surgery.The sperms that are found can be used to get test tube baby(ICSI done-embryos formed).Conventional testicular biopsy involves taking multiple random testicular biopsies. Sites of spermatogenesis limited and not predictable.
Advantages of MicroTESE
Micro-TESE has the advantage of allowing microsurgical exploration of the entire testicular parenchyma to maximize the chance of finding sperm while
* Sperm retrieval rates are higher
* Amount of tissue removed is less
* Testicular trauma is less
* Hormonal difference in testosterone after micro-TESE vs conventional is less
* This procedure is becoming standard of care for patients with NOA
(The author is Consultant Bournhall International)
dr. richasharma@hotmail.com
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