In-Vitro Fertilisation (IVF)
MESA treatment India offers information on MESA Doctor India, MESA treatment Hospital India, MESA treatment Abroad, MESA causes, symptoms, Risk factors, treatment. Option Advantages Disadvantages MESA * ? Blood contamination Lots of sperm back/? Retrieval rates ? Risk of hematoma Best pregnancy rates Requires microsurgery expertise ? Cost General anesthesia Requires scrotal exploration ? Post-operative discomfort PESA No microsurgery expertise required Local or general anesthesia Few instruments required Fast/Repeatable Minimal post-operative discomfort ? Cost Feasiblility depends on anatomy Less sperm back Blood contamination ? Risk of hematoma Damage to adjacent tissues TESA No microsurgery expertise required Local or general anesthesia Few instruments required Fast/Repeatable Minimal post-operative discomfort ? Cost Less sperm back Blood contamination ? Risk of hematoma Risk of testicular damage/atrophy TESE No microsurgery expertise required Local or general anesthesia Few instruments required Fast/Repeatable If non-obstructive azoospermia, Then less sperm back. Risk of testicular damage/atrophy Scrotal exploration required Micro-TESE* Few instruments required Best for Non-Obstructive Azoospermia Microsurgical expertise required. General anesthesia Not fast/Time consuming Scrotal exploration required ??? Cost ?? Risk of testicular damage ?? Post-operative discomfort Minimally repeatable * Requires microsurgical expertise with fellowship-training preferable. 
Microepididymal sperm aspiration (MESA) has perhaps been the procedure most commonly performed in men with vasal obstruction. A scrotal skin incision is made, and the testis and epididymis are exposed. Using an operating microscope, a single epididymal tubule is opened and sperm aspirated. This procedure may be performed with a general anesthetic, or a local anesthetic with intravenous sedation. An operating microscope is used to examine the very small tubules of the epididymis that contain the sperm. A dilated tubule is opened and the fluid is collected and examined for the presence and quality of sperm.
All of the sperm containing fluid is collected and taken to the IVF lab for processing, use and freezing. If the fluid is devoid of sperm or only dead sperm are found, then another area of the epididymis is sampled. This is done until enough sperm are obtained to use and to store for future use. Adequate numbers of sperm are often retrieved allowing for cryopreservation and future ICSI cycles. With the advent of microsurgical epididymal sperm aspiration (MESA), sperm are retrieved in higher numbers than with PESA, allowing for cryopreservation of large numbers of sperm.
Which Option is Best for Us?
Having so many options is great because “one size does not fit all.” A comprehensive male fertility evaluation and a careful discussion with you and your partner will determine which option is the safest and the most efficient way to locate and retrieve sperm for you.
Each option has its advantages and disadvantages:
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