Infertility treatments such as intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF) make it possible to extract a single sperm and use it to fertilize an egg directly. The latest surgical sperm retrieval techniques combined with ICSI and IVF also mean that infertility can be overcome even in men who produce hardly any sperm, or whose sperm never make it to the ejaculate because of an obstruction or another issue with the system transporting sperm.
MESA is a complex technique used by expert fertility specialists at Fertility & Genetics for the retrieval of sperm. Sperm is retrieved from the epididymis of men in whom transport of sperm from the testicle to the ejaculate is not possible because the drainage (ductal) system is absent or is not subject to reconstruction.
The fertility issues requiring MESA most commonly occur in men with vasal agenesis, a condition in which the vas deferens or drainage system of the testicle fails to develop prior to birth. The majority of these men have mutations of the cystic fibrosis (CF) gene. This means their female partner requires CF testing to ensure the embryo is not at risk for this mutation.
In some circumstances, the obstruction may be acquired after a failed procedure called epididymal vasal anastomosis. MESA may be indicated in these cases as well.
While the male is being evaluated as a candidate for MESA, his partner undergoes screening in our IVF program. MESA and IVF-ICSI complement each other and are an essential component of our assisted reproduction laboratories. Epididymal aspiration may be performed on the day of the woman’s egg retrieval or, ahead of time, and the aspirated sperm cryopreserved.
The success of pregnancy from this procedure is reported to be 25-60 percent, depending on female factors. It’s a complex process, requiring significant manipulation of the human gametes (eggs and sperm) but one that offers a previously sterile couple the chance of establishing a pregnancy using their own genetic material. Dr. Abaé discusses the procedure with you in detail, including possible complications as well as expected outcomes, if he considers you a good candidate for MESA.
Feel free to email us regarding any scheduling or general questions!