New study gives hope to increase success rates of microdissection testicular sperm extraction (sperm retrieval technique) for men with no sperm in the semen
One in 100 men in the United States have no sperm in their semen and 10-15% of men evaluated for infertility will have no sperm in their semen. In such cases where there is not sperm in the semen due to a cause other than a blockage not allowing the sperm to reach the semen, there is a specialized procedure termed microdissection testicular sperm extraction (microTESE) to give these couples a chance to conceive with the man’s sperm and the woman’s egg using sperm retrieved directly from the testicle. This is a meticulous microsurgical technique used to look for possible pockets of sperm production throughout the testicle under the visualization of an operative microscope to find sperm that can be used in combination with in vitro fertilization (IVF) to achieve a pregnancy. The success rates of retrieving sperm using this procedure are highly dependent on the training and experience of the microsurgeon.
I have recently published a basic science study in the May 2012 issue of the Journal of Urology examining a way to improve these outcomes (Smith,Lowe, Kavoussi, Steers, Costabile, Herr, Shetty, Lysiak. Confocal fluorescent microscopy in a murine model of microdissection testicular sperm extraction to improve sperm retrieval. Journal of Urology. 2012 May;187(5):1918-1923.) This study looked at our ability to identify microscopic pockets of sperm production by fluorescently labeling the sperm cells in a mouse model mimicking the testicular architecture of men with no sperm in their semen. This is a first step in applying such technology to men in this situation. More studies will certainly be needed before being able to apply this to humans, but this is a landmark step in that direction!