MICROTESE, PESA, MESA

In the absence of spermatozoa in the semen due to a disturbance of their formation (obstructive azoospermia), microsurgical testicular biopsy (MicroTESE) is used. The essence of the procedure is to search for the thickest seminiferous tubules, which often contain male germ cells with the aim of their further use in various types of artificial insemination.
Efficiency of MicroTESE in terms of detecting spermatozoa reaches 40%, which is several times more effective than conventional testicular biopsy.
In the absence of spermatozoa in semen due to obstruction of the seminiferous tubules (obstructive azoospermia), it is possible to extract spermatozoa from the epididymis either through the skin of the scrotum or microsurgically.
Percutaneous epididymal sperm retrieval (PESA) is performed using a needle that is passed into the tissue through the skin.
Microsurgical epididymal sperm extraction (MESA) is performed using an operating microscope and requires a rare qualification in microsurgery from the operating urologist.
The effectiveness of MESA in terms of obtaining valuable sperm for subsequent artificial insemination is 2 times higher than in the percutaneous technique (PESA).