MICRO TESE

What is Micro TESE?
TESE is the microscopic extraction of sperm from testicular tissue in patients whose ejaculate (semen) contains no sperm cells. In cases of male infertility, the ESE or Micro tese method is one of the latest techniques to be applied.

How is Micro TESE applied?

In the TESE procedure, sperm is extracted from the testicular tissues using anesthesia. The tissues of the testis contain spermatogonia, which facilitate the formation of sperm cells. These are tail-forming, motile sperm cells, which mature into normal sperm cells in special liquids. However, due to malfunction in the body, these cells were unable to develop into healthy sperm. The genetic material in these cells is identical to that in a normal sperm cell, but they can be obtained in a non-motile state in which they have not yet formed a tail. This yields only the sperm cell's main cell body, which, despite being immobile, contains all of the cellular components necessary for fertilization. The sperm cells found are transferred to the egg with the ICSI (microinjection) process.
In the TESE method, samples of tissue will be taken from the testis. The micro tese method, on the other hand, reduces the testicular damage caused by the TESE method. A microscope is utilized during the surgical procedure, which is technically identical to the TESE technique. With the aid of a microscope, sperm-producing channels can be observed in great detail. The sperm-producing ducts are distinguishable due to their larger size. The surgeon identifies and collects from these areas. Consequently, the rate of sperm detection is multiplied by a significant amount compared to the TESE method.

Who is Treated with Micro TESE?

TESE is a surgical procedure performed on men who lack sperm cells in their semen. The absence of sperm cells in the semen can be due to several reasons:

1. Obstruction in sperm ducts.

2. Congenital absence of sperm ducts.

3. Hormonal causes.

4. Genetic causes; The genes that enable sperm production in men are on the Y chromosome. Problems in these genes affect sperm production.

5. Radiation, particularly radiation used to treat cancer, has the potential to permanently halt sperm production.

6. Certain medications, particularly those used to treat cancer, can permanently halt sperm production.

7. Infection (Post mumps)

Points to Consider Before Micro TESE

1. You should not consume anything, including water, for at least six hours prior to the procedure.

2. Clean the procedure area with a razor blade. Take a bath.

3. Bring loose pants or sweatpants, as pressure on the testicles will cause discomfort after the procedure.

4. You will be discharged 1-2 hours after the procedure.

Points to Consider After Micro TESE

1. Liquid food intake can be started within 3 hours after the procedure.

2. You can take a bath on the 5th day after the procedure.

3. Abstain from sexual intercourse for a week.

4. If you have pain, you can use painkillers.

5. If you experience redness, swelling or bleeding at the procedure site, inform your doctor.

6. Since self-dissolving sutures are used during Micro TESE, there is no suture removal process. The stitches will dissolve on their own in 7-10 days.

Risks

It is possible that viable sperm cells may not be obtained through micro TESE. This risk depends on the underlying cause. The chance of finding sperm in a patient with obstruction in the sperm ducts is higher than the patient with hormonal or genetic problems. Postoperatively, infection and bleeding may occur at the operation site.
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