Non Obstructive Azoospermia (NOA) is a condition where there are no sperms in the ejaculate. Traditionally they were considered infertile With the advent of operating microscopes and the ICSI (Intra Cytoplasmic Sperm Injection) technique. Micro TESE is able to help these men father their own children
In this technique, the male undergoes rigorous evaluation as to why he developed azoospermia in the first place. Once we are sure with the genetic constitution of the male, we plan for sperm retrieval. Initially a TESA is done to identify if sperms can be retrieved.
If TESA is negative for sperms, in the same sitting, Micro TESE is done.
MicroTESE is done by bivalving the testis under the operating microscope (15-20 X) and sperm bearing seminiferous tubules are identified by experience. Once these tubules are identified, they are teased and the embryologist under the light microscope identifies sperms and their quality.
This procedure is carried out religiously and untiringly till we get the apt quality of sperms for ICSI. There are few conditions like Sertoli only cell syndrome, where the chances of sperm retrieval is only 5% but we should note that one good sperm can be enough for a successful ICSI.