Sperm Retrieval Procedures
Sperm harvesting is entirely different from a diagnostic testicular biopsy because, in this setting, the goal is not to identify what is happening in the testis but instead it is to find sperm. Only men with no sperm in their ejaculate need to have sperm retrieved directly from the testis or epididymis.
This may involve a simple aspiration for men who have a blockage or require much more extensive sampling of the testis for men who have a sperm production problem. As a result, there is a significant difference in the amount of time it takes, the need for anesthesia and the equipment utilized.
Very few tests allow for an accurate prediction of whether or not sperm will be found in the testes of men with testicular problems. Genetic testing may give insight into the chance of finding sperm but are not absolute. The pattern of the problem of the testis found at the time of a diagnostic testicular biopsy may be slightly predictive, but again there is no finding that absolutely predicts the presence or absence of sperm. Other blood tests, including hormonal studies, are not predictive.
Finally, even having sperm found on a previous harvesting session does not guarantee that sperm will be found on future harvesting attempts. Thus, diagnostic testicular biopsy is not routinely performed in patients who are to undergo testicular harvesting of sperm when the cause of their zero sperm count is already established through other means.
The Timing of Sperm Retrieval
The timing of sperm harvesting in conjunction with the in vitro fertilization (IVF) cycle is a difficult matter to resolve. There are advantages for and against doing the sperm harvesting prior to the IVF cycle or in conjunction with the harvesting of the female partner’s eggs. The ultimate decision is made by the preference of the IVF program. Performing the harvesting in advance and freezing the sperm until the eggs are harvested allows the couple to make an informed decision about whether to go forward with IVF, since in most circumstances the chance of finding sperm may be only 60 percent or less.
Moreover, it is difficult for many couples to undergo operative procedures the same day because it requires their enlisting other resources to help them get to and from the hospital and to provide assistance at home. IVF laboratories frequently prefer to work with fresh rather than frozen sperm and thus their desire to have fresh sperm trumps any other consideration.
As a result, simple sperm retrievals are typically performed the day of egg retrieval. Simple sperm retrievals are procedures performed in men with a known obstruction who make sperm without a problem. These procedures are summarized below, and include testicular sperm aspiration (TESA), percutaneous sperm aspiration (PESA) and testicular sperm extraction (TESE).
Microdissection TESE (MicroTESE) is a much more involved procedure and is performed the day before the female partner’s egg retrieval. MicroTESE is carefully coordinated with the reproductive endocrinologist and is performed at designated times on a quarterly basis.
Cost of Sperm Retrieval Treatment
The average cost of a ICSI Treatment in Europe is €3,000. But the prices in Iran and Turkey are much lower than USA and Europe and even lower than India. To see the price, visit the Treatment-Prices.
Related Packages
