臺北榮民總醫院國際醫療中心
Microdissection-TESE and In Vitro Fertilization (IVF)

Microdissection-TESE and In Vitro Fertilization (IVF)

 

Specialist:

William J Huang

Chen-Yu Huang

Her Ji Horng

 

Feature Summary

The most challenging task in male infertility is azoospermia. For these patients, our fertility specialists, urologists, and embryologists provide the best standard of service in Taiwan. The cumulative live birth rate for couples with azoospermia is above 40% in our hospital. In 2021, we had the first live birth after round spermatid injection (ROSI) in Taiwan.  

 

Overview

Infertility is the failure to conceive after 1 year of regular unprotected intercourse. In general population, about 1% of men have no sperm in semen (azoospermia). Azoospermic patients can further be diagnosed as either obstructive or non-obstructive. If any mechanical blockage occurs along the reproductive tract, it is called obstructive azoospermia. Because the sperm production is still normal, mature sperm could be easily retrieved from testis or epididymis. For non-obstructive azoospermia, the sperm production is compromised, and microdissection testicular sperm extraction (mTESE) is necessary for sperm retrieval for further IVF therapy.

 

Procedure

For couples with azoospermia, the adequate number of eggs should be cryopreserved before sperm extraction. The cryopreservation of eggs involves ovarian stimulation, ultrasound guided egg retrieval, and egg vitrification.

The microdissection testicular sperm extraction (mTESE) is performed by urologists under general anesthesia. Our urologists use surgical microscope to search normal seminiferous tubules in the testis and scoring sperm cell by innovative immediate table side touch print smear technology. Thereafter, our embryologists pick sperm cell up from the retrieved testicular tissue and perform intracytoplasmic sperm injection (ICSI) to fertilize the eggs. Finally, our fertility specialists transfer the embryos to the uterus and a pregnancy test is done approximately two weeks later.

 

 mTESE + ICSI needs four microscopes to take care each sperm cell.

 

Estimated Cost

For estimated medical costs, please contact International Medical Services Center.

 

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