Microsurgical sperm extraction is one of assisted reproductive methods used to treat male sterility.
Microsurgical sperm extraction is a method of obtaining sperm from the epididymis (MESA) and the testicles TESE (TESE). The sperm is obtained from the male by surgery under total anaesthesia.
An embryologist and an andrologist will check the tissue for the presence of sperm immediately after taking a sample of the tissue from the testicle and the epididymis. When sperm is obtained, in vitro fertilisation using the ICSI method and embryo transfer will follow.
The MESA/TESE method is intended for men who do not have sperm in the ejaculate (azoospermia), but there is also a presumption of their formation and occurrence in the testicles.
In case of natural conception, the egg is fertilized in the fallopian tube. After fertilization, the embryo continues into the uterine cavity. This journey takes about 6 days.
With extended cultivation, the embryos are transferred to a special medium on the third day and we cultivate it until the blastocyst stage. In this way, we create similar conditions for the embryo by putting it in the uterus at the same time as in case of natural conception, and the embryo stage is the same as well. Thus, we create for the embryo better conditions for implantation compared to classic three-day cultivation. Only about one third of the embryos reach the blastocyst stage. We will select quality embryos that have reached this stage by prolonged cultivation
Prolonged cultivation provides benefits for most female patients. It helps us to select the best quality blastocysts because of the higher number of embryos. The advantage of this method is also to obtain information about the process of division for patients with fewer embryos.
Magnetic sperm separation is a method of eliminating sperm with damaged DNA from the patient’s ejaculate. Sperm at the end of their life cycle have an increased incidence of DNA breakdowns, which can lead to erroneous development of the future embryo. At the same time, these cells are characterised by changes in the cell membrane structure by which they are able to bind to specific nanoparticles.
When the solution passes through the column, these nanoparticles are separated by a magnetic field. Healthy sperm do not bind with nanoparticles and therefore pass through the column freely.
The MACS method is designed for patients with increased values of sperm DNA fragmentation. It is also suitable for couples with which the embryos were slower to divide in the earlier cycles because of paternal genome damage.
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