For the best part of your teenage years and beyond, you are probably worried about death that you may get someone pregnant. The irony is that now, when you are all installed and ready to build a family, you can’t! Your sperm is either nowhere in your sperm, or what is not useful. I’m not sure who said this, but it’s another case “if you want to make God tell him about your plans.”
The best sperm can be found where it is made: in this priceless family jewelry called the testicle. Along with your bravery, you have also passed the best part of your life by protecting these jewelry from, as the US postal service says, snow, rain, heat and night sadness. Now, against any hope and desire, one suggests that you get a knife to your scrotum. Here’s what you need to think about if this is your situation.
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The testicles have two jobs. The first is to do the sperm, which usually do at a worrying rate of 1000 sperm/heartbeat. The second is to become testosterone, most of the male hormones. Although most sterile men (with sperm dysfunction) actually have normal testosterone production, it is also true that surgical fishing for sperm in the testicles can lower testosterone levels. And this, my friends, means early “manopause” as well as the need for lifelong testosterone replacement years earlier than can normally happen. Sure, this is a quality of life that men would like to avoid if possible.
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Believe me, having a test of testicular sperm recovery (TESE) is nothing like providing a sample sperm for IVF. Post-war pleasure is replaced by anxiety, fear and pain. Here are 10 questions to consider if a TESE process is hidden in your future:
Is it necessary to recover the sperm of the testicles?
If the problem is Azospermia due to non -productive causes (eg deleting chromosomes, cancer chemotherapy), then yes, the testicle is the only place where sperm will be found. Blocking due to genetic or obtained causes, then the epididymic sperm (MESA) can be an alternative sperm source that avoids damage to the testicle. If you have very few ejaculated sperm (Cryptozoospermia), then an extremely sperm laboratory expert may be able to find enough good sperm from Ejaculate to avoid TESE procedures. Similarly, if you have a lot of evil sperm sperm (that is, it is extremely fragmented DNA), then the sperm sperm sperm may be a less invasive alternative to TESE procedures.
Which technique is used?
Needle suction procedures (TESA) are less invasive and detrimental to the testicles than the biopsies (TESE) and much less invasive than petty biomes. Shoot for the less invasive approach you can, which should be possible in all cases 1/3 of cases of non -productive azoospermia.
What is the opportunity to find something?
In cases of obstruction or obstruction, the likelihood of taking the sperm is 100%. With non -productive azoospermia, ranges from 50-60% Depending on the cause, the surgeon and the workshop.
Can we improve the likelihood of finding sperm?
This applies only to non -productive cases. Predictive algorithms do not help much here. Optimized health and hormonal levels are of some value and must be pursued before sperm recovery. The most important way to predict in advance if the sperm will exist in TESE procedures is to make a FNA mapping process. If the map displays the sperm, then there is a 95-100% probability that a subsequent sperm recovery process will find it again. It can also let you know if a TESA/TESE or Microtese process is required to obtain sperm. If the FNA map does not show sperm then alternatives to TESE should be taken into account as the probability of successful sperm recovery is <2%
How much semen will we find?
This is a good question for the surgical team and a good measure of expertise. In my view, finding a digital number of sperm is unlikely to lead to successful pregnancy, since not all eggs are fertilized and not all fertilized eggs are developed in useful embryos. One has to shoot for at least 3 times more sperm than eggs to give embryologists a choice between sperm and allow frozen extra sperm and avoid another process.
Do I have to do the process first and get sperm down?
If you look at large studies of many patients coach, frozen and thawed testicular sperm seem to “perform” with IVF as a freshly cut sperm. But it is difficult to apply population data in individual cases and I have published that fresh sperm is twice as viable and usable by the sperm. And that is why I prefer to offer fresh sperm whenever possible: because it is the best sperm in many ways.
Should i do it again?
A good quality TESE process will provide enough sperm for several IVF cycles, and this should be a top priority for the surgeon. This helps to avoid recurring procedures and the testicles remain healthier. Obtaining adequate sperm for several IVF cycles is also more likely to occur when FNA mapping is performed, as the richest sperm pockets are known in front of time.
What can go wrong?
Always ask about complications of TESE procedures as they can happen. Some swelling and black and blue skin is not uncommon. However, infection, hematoma, bleeding, chronic pain and testicular loss should be << 1% in the best hands.
What is the probability of my testosterone fall?
This depends on how aggressively a TESE process becomes. Risk factors include larger incisions and more tissue removal. This makes TESA processes the least dangerous and small -scale processes the most dangerous to change testosterone levels. Shoot for the minimum invasive TESE methods to have happier, healthier testicles.
Will the testicles look different after?
With the TESA or TESE procedures, your testicular appearance is not affected. After the procedures of the small ones, there is a possibility of smaller size and modified shape.
My hope is that this checklist provides some level of comfort that you do everything you can to get the best result from the TESE process. It is inspired by the “measure twice and cuts once” a philosophy I have kept dear for my entire surgical career.
To schedule a consultation with Dr. Turek in Los Angeles or San Francisco, call 1-888 -ctarekmd today.
