In vitro fertilization (IVF) is a sophisticated form of assisted reproductive technology (ART). It involves controlled ovarian hyperstimulation, retrieval of eggs from the ovaries, fertilization with sperms in the laboratory and embryo transfer into the female partner’s uterus.
IVF has been successfully used to treat infertility caused by both sperm and egg factors. In order for fertilization to occur, an egg and a sperm must meet in the same time frame during the menstrual cycle. In couples where this is not possible, artificial insemination with a sperm injection (IUI) or donor sperms can be done to achieve a pregnancy.
Azoospermia, a condition where no sperm is present in the semen, can be treated using a specialized technique called Microsurgical Epididymal Sperm Aspiration or MESA. MESA is a surgical procedure in which the urologist, under the operating microscope, opens the small tube-like structures called the epididymis and retrieves the sperm-containing fluid. This sperm can then be combined with an egg from the partner under a high-magnification process called Intra Cytoplasmic Sperm Injection or ICSI. In many cases, azoospermic men have been successfully conceived with this ART treatment.
MESA is also done for men who have vasal or epididymal obstruction (s/p vasectomy or congenital bilateral absence of the vas deferens). It is performed under general anesthesia and utilizing the operating microscope and is typically done in conjunction with the female partner’s egg retrieval. This procedure allows for a more extensive collection of mature sperm as compared to aspiration techniques and is the preferred method of sperm retrieval in men with congenital bilateral absence of the vas testis since it does not impact testis steroid production. Often, enough motile sperm is obtained with MESA that it can be cryopreserved for future IVF cycles. in vitro fertilization mesa