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Micro-TESE is a surgical procedure used in the treatment of male infertility caused by sperm-related issues. In cases where azoospermia is diagnosed, Micro-TESE is performed to obtain sperm from the testis, enabling the individual to have children through the IVF method.
Micro-TESE is a surgical procedure used in male-related infertility cases. Thanks to this procedure, sperm is extracted from the testes of men who have no sperm production (azoospermia), so that they can father biological children. In rare cases, micro-TESE is performed on men with poor sperm quality to obtain healthy sperms.
There can be different causes for the absence of sperm cells in the semen. These causes are listed as follows:
• Ejaculatory duct obstruction
• Undescended testes
• Hormonal causes
• Missing sperm ducts (from birth)
• Genetic causes
• Use of medication
• Various infections
• Exposure to radiation
However, in about half of the patients, the causes of the absence of sperm in the semen remains unknown.
In the micro-TESE procedure, the testis is completely opened with a single incision. The tissue is then magnified 24 times with a microscope to identify areas likely to produce sperm. As sperm-producing channels are easily seen and recognised, the urologist performing the procedure can collect the necessary tissues. These tissue samples are subjected to a number of treatments to separate the live sperm cells therein. If live sperm is found, and the eggs collected from the mother are ready for microinjection, the IVF procedure is performed straight away. If there are any remaining sperm cells, they are frozen and stored for future IVF treatments.
The micro-TESE procedure yields a much higher number of spermatozoa than conventional biopsy methods. Another advantage of the micro-TESE procedure is the following: since the magnification under the microscope allows for a much better observation of the vessels, damage to the testes is minimised.
Micro-TESE is performed in an operating room under general anaesthesia and lasts about 1-2 hours. Fasting is necessary starting six hours before the surgery. After the micro-TESE surgery, the patient is kept under observation for 3-4 hours. After patient discharge, home rest is recommended for 3-4 days. The patient should not engage in heavy work for 10 days and should stay away from physical activity.
Following the micro-TESE procedure, patients are discharged after the effect of the aesthetic effect is subdued (2-3 hours).
• It is recommended that the patient not drive on his way home after Micro TESE operation.
• Postoperative patients should abstain from sexual intercourse and physical activity.
• The wound should be dressed 48 hours after the operation.
• Patients can shower 3 days after the micro-TESE operation.
• After the procedure, patients are recommended to wear tight underwear and a jockstrap.
• Stitches will dissolve within a week of the Micro-TESE procedure.
The question: “How many times can I have Micro-TESE surgery” does not have a definite answer. First of all, the medical symptoms of the patient and the results of the past TESE procedures should be assessed. After this assessment, a decision is made as to whether the TESE procedure should be repeated. When necessary, the Micro-TESE procedure can be repeated.
If no sperm is found during the micro-TESE procedure, the collected tissues absolutely need to be sent to pathological examination. The pathological diagnosis resulting from this examination will determine the possibility of sperm retrieval in subsequent TESE procedures. If the pathological diagnosis is positive and sperm stem cells are found, a TESE operation can be repeated.
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