If any bleeding occurs from the epididymal tunic, focal bipolar electrocautery may be used for hemostasis. The aspirated fluid is checked for sperm. Since no microsurgical dissection or suturing is involved, the procedure is very quick, does not need special equipment or training, and can be performed under local anesthesia in the operation theatre of the ivf unit. This procedure can be repeated on the same or opposite side until sufficient sperm are obtained for. In the current era of assisted reproductive technology, sperm retrieval rates for oa should approach 100% regardless of the technique. As described above in the section on mesa, because sperm gain maturity through epididymal transport, the sperm should be surgically extracted from the distal-most epididymal location where quality motility is observed, although rarely are viable sperm available as distally as the epididymal tail. Epididymal sperm retrieval was initially performed using open, microsurgical technique commonly referred to as microsurgical epididymal sperm aspiration (mesa).
Mesa sperm retrieval procedure. If pesa fails then ofna or nab is done. In this situation an extended sst technique is used–the opening is widened a little so that both prongs of the micro-forceps can be pushed into the depth of the testicular tissue; the deeper tissues are grasped and the forceps is pulled out; fibrous tissue gets left behind and the better tubules are extracted. Micro epididymal sperm aspiration is where sperm is aspirated directly under vision from the epididymis. Scrotal exploration performed and testis is delivered into the wound in order to avoid any injury to the epididymis.
Dartos fascia and skin are each closed with 3-0 chromic in a running fashion (. While any aspiration technique can be used during miesa, including the selective aspiration of a tubule with the glass capillary tube, we prefer the obliterative mesa technique of aspiration to maximize the amount of sperm retrieved. The good news is these males also have about a.