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Asian Journal of Andrology (2013) 15, 40β43; doi:10.1038/aja.2012.114; published online 19 November 2012
Microsurgical epididymal sperm aspiration: indications, techniques and outcomes
Aaron M Bernie1, Ranjith Ramasamy1, Doron S Stember2 and Peter J Stahl3
1 Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY 10021, USA
2 Beth Israel Medical Center of Albert Einstein College of Medicine of Yeshiva University, New York, NY 10003, USA
3 Columbia University College of Physicians & Surgeons, New York-Presbyterian Hospital, New York, NY 10032, USA
Correspondence: Dr PJ Stahl, (ps2192@columbia.edu)
Received 10 September 2012; Revised 3 October 2012; Accepted 3 October 2012
Advance online publication 19 November 2012
| Abstract |
Microsurgical epididymal sperm aspiration (MESA) refers to retrieval of sperm-containing fluid from optimal areas of the epididymis that are selected and sampled using high-power optical magnification provided by an operating microscope. Retrieved sperm are subsequently used for intracytoplasmic sperm injection (ICSI) to induce fertilization and pregnancy. MESA is considered by many experts to be the gold standard technique for sperm retrieval in men with obstructive azoospermia given its high yield of quality sperm, excellent reported fertilization and pregnancy rates, and low risk of complications. However, MESA must be performed in an operating room, requires microsurgical skills and is only useful for reproduction using ICSI. Herein we present an overview of the evaluation of candidate patients for MESA, the technical performance of the procedure and the outcomes that have been reported.
Keywords: azoospermia; ICSI; infertility; male; MESA; microsurgical epididymal sperm aspiration; microsurgery; sperm retrieval |
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