For some patients, ejaculation is impossible, or little or no living or motile sperm can be recovered from their ejaculate. Examples of this include patients with prior vasectomy, patients born with congenital absence of the vas deferens, and with zero sperm count due to other causes. However, these men frequently have sperm in the testicles. Sperm can be harvested directly from the testes through Testicular Sperm Aspiration (TESA) or Testicular Sperm Extraction (TESE). Because a low number of sperm can be collected this way, and because testicular sperm cannot fertilize an egg on its own, TESA must be used along with In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI).
Prior to TESA, men with no sperm in their ejaculate required much more involved surgery to recover sperm from their testes. This operation would require hospitalization and lengthy recuperation time, as well as high costs. Testicular Sperm Aspiration -TESA is a fast procedure performed right in the office, requiring only local sedation, and costs much less than surgery.
Some patients have a very small amount of motile or living sperm in their semen. To increase the amount available for use in IUI, IVF and ICSI, sperm can be frozen (cryopreserved) and stored at the Reproductive Fertility Center cryobank for use in future fertilizations. Cryopreservation can also be used to store unused semen and sperm samples to prevent the need for further sperm aspiration.
Vasectomy reversal is performed a tube known as the “vas deferens” is cut. Cutting of tube is vasectomy procedure. Each man has two vas deferens, which carries semen from a testicle to the penis. After vasectomy man still produces sperm in the testicles but it cannot flow to the penis after ejaculates, and is instead reabsorbed by the body. Vasectomy reversal therefore involves reconnecting the vas deferens tubes at the point where they were cut. This is a very delicate process and must only be performed by well experienced and board certified doctor.