Micro Tese Surgery Turkey

What is Micro TESE?

It is a surgical procedure performed in cases where there is no sperm in the semen (azoospermia) in the male member of couples complaining of infertility. The testicle is opened with the help of a microscope under anesthesia and sperm is tried to be obtained from the tissues inside.

What is azoospermia?

The absence of sperm in the ejaculated semen fluid is called azoospermia. For the diagnosis of azoospermia, two semen analyses should be made at 2-week intervals and it is recommended that these samples be centrifuged twice. The situation where no semen comes at all is called aspermia.

What does Micro TESE mean?

The literal meaning of Testicular Sperm Extraction (TESE) under microscopy is the separation of live sperm, if any, by removing the appropriate seminiferous tubules in the inner tissue of the testicle.

How does Micro TESE differ from other methods?

With microdissection TESE, unlike classical techniques, more live seminiferous tubules are visualized and sperm is obtained. This method has been proven to be more successful by scientific research.

How is micro TESE performed?

After the sperm analysis, necessary hormonal, genetic tests and physical examination of the candidates for this procedure are performed, this procedure is performed under appropriate anesthesia. Anesthesia can be general, regional or local. The patient and physician decide together on the choice of anesthesia method. The procedure is performed with a small incision made in the sac called the scrotum where the testicle is located. Then, sperm is searched from suitable tissues under a microscope. Since it needs to be continued for a while until sperm is found, the procedure can take up to 2 hours.

Who is a good candidate for micro TESE?

The candidates for micro TESE are azopermic men who do not have blockages in their semen ducts. In some men, sperm cells that advance in the sperm ducts, mix with the semen in the prostate and are expelled cannot be found, while sperm cells that maintain their vitality but cannot advance are found in the testicle. Thanks to the micro TESE procedure applied for this purpose, these sperms are found, frozen and made ready for the IVF (in vitro fertilization) procedure to be applied later.

Success rate of Micro TESE

The success rate of finding sperm with the first Micro TESE procedure is around 50-60%. If sperm cannot be obtained with the first procedure, 20-30% of sperm can be found with the second micro TESE performed 6 months later. If it was found in the first procedure, this rate increases to 80-90%.

When will the micro TESE result be known?

Since the seminiferous tubules obtained with this procedure are immediately examined by the relevant embryologist, the final result is largely known within 1-2 hours.

What happens if sperm cannot be found in micro TESE?

If sperm cannot be obtained with the first micro TESE procedure, the micro TESE procedure should be repeated approximately 6 months after supportive treatment. The point that should not be neglected is that genetic analyses should be performed before the micro TESE procedure and that this procedure should not be performed unnecessarily in patients with AZFa, AZFb microdeletions.

Can Micro TESE be repeated if no sperm is found?

This varies according to the factors specific to each patient. In individuals who cannot obtain sperm with the first micro TESE procedure, a second procedure can be performed after 6 months. The point that should not be forgotten is that repeated micro TESE procedures are less successful than the first procedure. In other words, the highest sperm retrieval success is in the first micro TESE procedure. In addition, these procedures should be applied considering that there may be decreases in testosterone levels as a side effect and that erection may also be impaired.

Micro TESE and In Vitro Fertilization (IVF) treatment

When live sperm is obtained after the micro TESE procedure, it is stored under appropriate conditions by the embryologist. Then, the mother candidate is prepared for the in vitro fertilization procedure by the gynecologist and obstetrician. The obtained quality sperm is injected into the egg obtained with the microinjection (ICSI) method and fertilization is achieved. When a sufficient number of sperm is obtained, the in vitro fertilization procedure can be performed several times.

Recovery after Micro TESE

Patients are usually discharged on the same day. It is rarely necessary to stay in the hospital. After the procedure, mild pain, swelling and bruising may occur in the testicular area. These are usually relieved with oral painkillers. Applying an ice pack is helpful. Your doctor may also prescribe antibiotics to reduce the risk of infection after the operation. You can do your daily work within a few days and return to work in an average of 1 week.

Is Micro TESE painful?

This procedure must be performed under anesthesia and there is no pain during the procedure. After the anesthesia wears off, there is usually mild pain and it heals within a few days with painkillers.

Is Micro TESE risky?

It is a low-risk procedure in the category of minor surgeries. Major complications are not expected. Since the patients who undergo it are already azoospermic, there is no serious concern about damage to the testicles.

Hospitals that perform Micro TESE

Micro TESE procedure is performed by Assoc. Prof. Dr. Arif Demirbaş in the operating room environment with modern microscopes at Doruk Nilüfer Hospital Turkey.

Comments and experiences of those who have had Micro TESE

The basic treatment method for male individuals diagnosed with azoospermia is micro TESE surgery. If a healthy pregnancy is achieved after the IVF (in vitro fertilization) process of the couples who have this method, which has a sperm retrieval rate of 50-60%, it will be a source of happiness for both the family and the medical staff.

Micro TESE cost in Turkey

Micro TESE operation fees may vary depending on the hospital factors, the experience of the relevant urologist and the patient's insurance conditions. The micro TESE surgery cost range 2000 to 4000 USD in Turkey

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