Men with poor semen analyses whose conditions are not treatable or unexplained may still have the option of using advanced reproductive techniques to achieve a pregnancy. Even those men with no sperm in the ejaculate are able to have some living sperm procured from them through surgical methods and achieve a pregnancy using the conventional technique of ICSI or the more advanced IMSI in which the digitally enhanced, magnified images of the sperm allow the embryologist to detect any structural alterations and abnormality that are otherwise hard to locate with conventional methods. Surgical sperm retrieval techniques like TESA (Testicular Sperm Aspiration), PESA (Percutaneous Epididymal Sperm Aspiration) & Micro TESE (Microdissection Testicular Sperm Extraction) ensure that even men who have no sperms in the ejaculate can opt for ART.
Milann Academy has launched two Training Certificate Courses in Andrology & Male Infertility which will train Urologists and General Surgeons interested in practicing and treating Male Infertility.
The Fellowship in Andrology & Male Infertility will cover Diagnosis and Treatment of Male Fertility, Diagnosis and Management of Obstructive and Non-obstructive Azoospermia, Vasectomy Reversal, Varicocele Repair, Surgical Sperm Retrieval – TESA /PESA/MESA/Micro TESE and Penile Reconstruction & Penile Implants as well as Sexual Dysfunction.
This procedure is performed for men who need to have sperm retrieved for IVF/ICSI. It is done under local anesthesia and is usually done on the day of Oocyte retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated. TESA is performed for men with obstructive azoospermia (s/p vasectomy). It is done as an out patient procedure and usually takes about 15 – 30 mins. Occasionally, TESA doesn’t provide enough tissue/sperm and an open testis biopsy is needed. No special preparation is required for the procedure.
PESA is similar in everyway to TESA except that PESA involves passing a fine needle through the skin into the epididymis to obtain sperm. It is also done under local anesthesia or sedation and performed as an out patient procedure and no special preparation is required.
This is a microsurgical procedure designed to retrieve sperm directly from the testicles when sperm are absent. A small incision is made in the scrotum. With the help of a microscope the surgeon will locate and carefully extract seminiferous tubules, which are the tiny tubes within the testicles where sperm are produced.
The sperm extracted through TESE, PESA or Micro TESE are invariably used for Intra Cytoplasmic Sperm Injection (ICSI) during the IVF-ICSI cycle. It can be used in the same cycle or frozen and used in subsequent cycles.
During the last decade, DFI (DNA Fragmentation Index) has emerged as an important biomarker in the assessment of male fertility potential. The test allows us to determine the ratio of healthy normal sperm to those sperm with DNA fragmentation Elevated DNA fragmentation rate has been shown to be more common in infertile men with unfavorable reproductive outcome as compared to fertile men.
Male infertility treatment of the highest quality is now available to those who have so far been hesitant to visit a specialist. Ruling out a male factor problem can move the process along and save a couple valuable time and financial resources. The really exciting news is that most of male infertility cases can be resolved with a combination of lifestyle changes and medical techniques.
This is a brief overview of male infertility and the training & Certificate Courses in Andrology & Male Infertility offered at Milann Academy. If you have any further queries, please reach us at academics@milann.co.in or for more information regarding our Courses please access our website www.milann.co.in/academics/ or call +91-7829192444 or +91-9513310580. We would be happy to be of assistance.
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