What is MESA and How is It Done?

One of the main causes of male infertility is the complete lack of sperm in the ejaculation, also known as the Azoospermia. This condition is classified as obstructive azoospermia in which there is obstruction or blockage of the duct caused by a trauma from the previous surgery, infection or congenital–birth defects like the complete absence of vas deferens or non-obstructive azoospermia , wherein there is testicular spermatogenesis but no sperm in semen.For such men, conceiving naturally has very less possibility and surgical sperm retrieval either from the vas deferens, epididymis or testis is the only best option available to conceive a baby.

What is MESA?

Microsurgical Epididymal Sperm Aspiration or MESA refers to the retrieval of sperm-containing fluid from epididymis that is sent for processing and extraction of sperms. This procedure is done using an operating microscope that provides the high optical magnification required for this procedure. To induce fertilization and pregnancy, the extracted sperm is directly injected into the partners egg by a process called Intracytoplasmic sperm injection or ICSI.

In Azoospermic men, by this sperm retrieval method over the years the biological paternity has seen to be possible.

How is MESA Done

Now let’s discuss on how MESA is done. Microsurgical Epididymal Sperm Aspiration is performed by inserting a fine needle from scrotum to epididymis. Then with the help of an operating microscope, the dissection of the epididymis is done. When the incision is made on the epididymis tubules, the fluid spills from them and pools in the epididymis bed.

This fluid is then aspirated and sent for processing in the laboratory, to extract sperms. Sperm found are used for IVF ICSI procedure. Once the sperms are extracted the ductule is closed. If no sperms are found another ductule is resected. If large number of sperms are obtained during MESA , it can be cryopreserved for future IVF ICSI attempts.

Who Needs MESA

MESA is typically performed in men with epididymis or vasa deferens obstructions. The clinical pregnancy rates using this sperm retrieval technique has been really good. MESA requires highly experienced microsurgeons and operating microscope and thus the cost involved in this procedure is high.