Micro Tese:

MicroTESE (microscopic testicular sperm extraction) is a process that extracts sperm from a man's reproductive system's testicular tissue. This medical treatment may be indicated for reproductive reasons if a man is unable to release or produce enough quality sperm naturally (to enable the man to father a child).

The chance of successful retrieval with microdissection testicular sperm extraction (micro-TESE) is up to 60%. Despite this improved success, the ability to counsel patients on their chances of sperm retrieval success prior to surgery has remained a challenge.

The treatment is often performed by a urologist, a specialist who specialises in the male and female urinary tracts as well as male reproductive systems, by making a few tiny incisions in the testicle and removing a little quantity of tissue. After removing the tissue from the body, it is inspected under a microscope for sperm.

Disease Overview:

Non-obstructive azoospermia (NOA) in Male

The most severe form of male infertility is nonobstructive azoospermia (NOA), which is defined as no sperm in the ejaculate due to spermatogenesis failure. NOA is caused by either intrinsic testicular dysfunction or insufficient gonadotropin production.

Non-obstructive azoospermia is a group of conditions that cause a man's sperm to be abnormal. All of these conditions produce a reduction in sperm production or none at all.

Disease Causes:

Preesticular and testicular causes of non-obstructive azoospermia can be distinguished.

Pretesticular Non-Obstructive Azoospermia: All pretesticular disorders interfere with a man's ability to produce sperm normally. If a guy has any of these diseases, he won't be able to create normal, healthy sperm.

Preesticular non-obstructive azoospermia can be caused by a variety of factors, including:

• Hypogonadotropic hypogonadism is a condition in which the pituitary gland fails to produce the hormones required to produce sperm or testosterone.
• Hypothyroidism.
• Certain drugs are used.
• Estradiol levels have risen.
• Kallman's syndrome is a condition that affects people.
• Pituitary tumours of a few uncommon forms.

These disorders are generally treated with drugs that are taken orally or by injection.

Testicular Non-Obstructive Azoospermia: When your testes are unable to produce normal sperm, this is known as testicular non-obstructive azoospermia.

Testicular non-obstructive azoospermia can be caused by a variety of factors.

The following are the most common causes of non-obstructive azoospermia:

Varicoceles are scrotal varicose veins that interfere with sperm generation in the testicle (but rarely lead to azoospermia).

Cryptorchidism or bilateral undescended testicles.

Testicular carcinoma is a malignancy of the testicles.

Radiation, chemotherapy, and several industrial chemicals are examples of gonadotoxins, which are harmful to the testes or gonads.

Immunologic reasons, such as post-pubertal mumps orchitis (a mumps infection in the testicle(s) of a male who has previously gone through puberty).

Sertoli-cell only syndrome (where there are no sperm cells in the testis).

When all of a man's sperm can only reach a given, incomplete stage of development, this is known as incomplete development.

Klinefelters syndrome, for example, is a genetic condition (this is when a man has an extra X chromosome, so they have XXY instead of XY).

Disease Treatment:

We treat non-obstructive azoospermia in the same way regardless of what's causing it. We begin with a male endocrine profile and sperm analysis (blood work). Then we utilise one or more of the therapies listed below:

Drugs/Medications: We normally start you on clomiphene citrate or clomid if you have low bioavailable testosterone. We redo the semen analysis after you've been on this medicine for four months.

After taking testosterone-lowering medicine, one out of every nine men will have their sperm return to the ejaculate. After taking medicine, some men's sperm do not return to their ejaculate.

Taking testosterone-lowering medicine, on the other hand, increases the odds of discovering sperm during a surgical sperm extraction process known as microsurgical testicular sperm extraction (microTESE).

Microsurgical Testicular Sperm Extraction (microTESE): For males who have enough testosterone* during diagnostic testing, we propose microsurgical testicular sperm extraction (microTESE). MicroTESE is also recommended for men who have been using testosterone-lowering drugs for at least four months but are still not producing sperm after ejaculation.

Approximately 50–65 percent of the time, clinicians can discover sperm with microTESE treatments.

*Note: Bioavailable testosterone differs from total testosterone, which is measured by many labs.