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Jun 12, 2014 — by Larry Lipshultz

A happy coupleMESA is an assisted reproductive technology (ART) treatment for men whose healthy sperm cannot travel through the reproductive tract to leave the body. UrologistLarry Lipshultz has helped many men, and couples, in San Antonio and other areas of Texas overcome reproductive issues with MESA sperm retrieval. Dr. Lipshultzoften performs the MESA technique as an alternative to vasectomy reversal, which reconnects the male reproductive tract.

Who Is a Candidate for MESA?

Many men want to have a child who shares his genes, but a congenital or acquired physical abnormality stands in the way. Those diagnosed with obstructive azoospermia, which occurs when semen contains no sperm, may benefit from MESA. With this condition, the man produces healthy sperm in an adequate quantity for fertilization, but the sperm cannot leave his body. Obstructive azoospermia can be caused by missing or blocked ducts, absence of the vas deferens, or problems with ejaculation. Issues such as diabetes, injury of the spinal cord, and neurological damage may be factors that keep sperm from being delivered to the urethra prior to ejaculation. 

Another case in which MESA may be effective is as an alternative to vasectomy reversal, when in-vitro fertilization (IVF) is going to be performed. The first live birth from the combination of MESA and IVF occurred in 1990.

What Is MESA?

MESA is an acronym for microsurgical epididymis sperm aspiration. While it has a lengthy name, this procedure has proven to be a simple solution for men whose sperm cells cannot travel from the testicles through the vas deferens and out of the body, so natural fertilization of an egg is impossible.

  • M=Microsurgical: Microsurgery is performed withtiny instruments, under a microscope.
  • E=Epididymis:The epididymis is located on the top of the testis, and it provides an estuary, of sorts, where sperm collect and mature.
  • S, A=Sperm Aspiration: Sperm aspiration refers to removal of sperm from the male, with a micropuncture pipet.

How Is MESA Performed?

A small incision is made at the midline of the scrotum. By opening the tunical vafinalis, the epididymis, located atop a testicle, is exposed. Then, under microscope, Dr. Lipshultz uses a micropuncture pipet, tubing, and syringes, or a MESA holder, to collect sperm. The quality and quantity of sperm varies by location in the epididymis, so collection may be performed in multiple areas. Direct retrieval keeps sperm from encountering blood, which can significantly impair sperm function and thus reduce its efficacy for successful fertilization.

The doctor examines the sperm under intense magnification to determine whether the collected specimen is valuable. Multiple aspirations can be made to ensure that a viable sample is acquired. Closing of the incisions completes the procedure. The specimen may be immediately used in an IVF procedure or cryogenically frozen for future use.

Schedule Your Consultation

If you have been diagnosed with obstructive azoospermia or seek an alternative to vasectomy reversal surgery, schedule a consultation with Dr. Larry Lipshultz today. He can provide a second opinion, as well as treatment options to help you and your significant other become pregnant.