How is it possible to achieve pregnancy with azoospermia?

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Natural pregnancy in a woman whose partner has secretory or obstructive azoospermia is not possible. However, when the treatments applied do not allow solving the problem, assisted reproduction offers a series of options that allow achieving pregnancy through in vitro fertilization techniques. We talk about them in this article.

Below you have an index with all the points that we will discuss in this article.

Index

Sperm aspiration

In men suffering from obstructive azoospermia, we do not see sperm in the ejaculate but there is sperm production in the testicle.

One of the options is to extract the sperm directly from the testicle or from the epididymis. In this way sperm can be obtained, although in low quantity and poor quality in relation to mobility and morphology.

Due to this, in case of obtaining sperm by aspiration, it will be necessary to resort to the ICSI technique (intracytoplasmic sperm microinjection).

ICSI is the ideal in vitro fertilization technique because only one sperm is needed for each ovule to fertilize. In addition, in this process, it is the specialist himself who introduces the sperm into the interior of the ovule.

There are several procedures to perform the extraction of sperm and their names come from the acronym in English:

TABLE

Corresponds to the name in English: microsurgical epididymal sperm aspiration, that is, microsurgical aspiration of epididymal sperm. It is used in patients with obstruction in the reproductive tract. It consists of making a small cut in the epididymis and extracting sperm from the epididymal interior.

Microsurgical sperm aspiration of the epididymis (MESA)

It is a complicated operation and the costs are high. For this reason, although it allows to recover more sperm than with PESA, it is not the technique of choice.

WEIGHT

It is the percutaneous aspiration of epididymal sperm (percutaneous epididymal sperm aspiration). It is a simpler and less invasive intervention than the previous one and does not require so much skill on the part of the doctor. It is done under sedation, so the patient does not feel pain.

Percutaneous epididymal sperm aspiration (PESA)

It is aspirated from the skin through a needle that is introduced through the scrotum to the epididymis. The drawback is that the insertion of the needle is done blindly and, although it is not usual, it is possible that no sperm is aspirated.

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