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Surgical Treatment of Male Infertility
Many factors contribute to male infertility, including age, nerve damage, and physical obstructions of the reproductive tract. In addition, low numbers or absence of sperm in the ejaculate may significantly impair the ability to conceive. Erectile dysfunction is the most common source of male infertility.
Luckily, male infertility is highly treatable. Electroejaculation (EEJ) is frequently successful in obtaining viable sperm by electrical stimulation of the prostate, even when no sperm is found in a semen analysis. During an EEJ procedure, two samples are collected. The antegrade contains the ejaculate. The retrograde is obtained from the bladder, where some sperm may have been lost during ejaculation.
If the male reproductive tract is blocked, other means may be necessary to retrieve viable sperm. Several procedures aspirate sperm from the epididymis, where sperm mature and sometimes accumulate. Percutaneous epididymal sperm aspiration (PESA) is minimally invasive and can be done under local anesthesia. Micro epididymal sperm aspiration (MESA) is slightly more involved. If sperm are not found in the epididymis by PESA or MESA, the testis may be explored by testicular sperm aspiration (TESA). Other options include collecting sperm during vasectomy reversal.
Cryopreservation of Surgically Obtained Sperm
Viable sperm obtained from any of these procedures are processed and cryopreserved by the laboratory for use in future IVF procedures. Specialized surgical procedures, such as those outlined above, are performed in collaboration with Dr. Samuel Thompson, urologist and male infertility specialist, of Urology of Indiana.
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