There used to be very few opportunities for infertile men to have biological children. Fortunately, advances in medicine now shine new hope for aspiring fathers. In particular, several surgical interventions exist that can resolve or bypass reproductive conditions that undermine male fertility.
Surgical Repair of Varicoceles
A network of veins is responsible for returning blood flowing through the testicles back into the rest of the body. Since blood needs to flow upward in this network, the veins have valves that prevent fluid backflow. However, these valves may fail to function adequately in some people, causing blood to pool. This condition is a varicocele, and it can hamper normal testicular function, including sperm production.
Fortunately, doctors can resolve varicoceles by surgically targeting the enlarged veins containing the malfunctioning valves. Surgery is performed on these damaged blood vessels to close them off. Hence, blood flow redirects to healthier veins, and the overall blood circulation in the testicles improves.
Sperm Obstructions and Surgery
Once sperm is produced in the testes, they are temporarily stored in the epididymis until orgasm occurs. During intercourse, muscular contractions propel the sperm through a tube called the vas deferens. Sperm cells mix with other fluids before passing into the urethra and out of the body.
However, some men experience mechanical issues with the pathway that carries the sperm. Infections or genetic disorders may cause obstructions to form inside the vas deferens. Surgical removal of these obstructions typically resolves many cases of male infertility.
In some cases, it might be impractical or impossible to establish a clear passageway for the sperm. Hence, doctors sometimes resort to procedures that obtain sperm cells directly from the testes or the epididymis.
In microscopic epididymal sperm aspiration or MESA, a small incision is made on the scrotum to access the epididymis. The surgeon uses a unique instrument called an operating microscope to examine the internal structure of the epididymis. Once viable sperm is found, the surgeon collects it for use in in-vitro fertilization techniques.
A related procedure called percutaneous epididymal sperm aspiration uses a needle to collect sperm without the need to make an incision. This procedure requires less intensive equipment and is simpler to perform.
In some cases, sperm counts remain low even in the absence of any obstructions. In this scenario, the testes produce very few sperm cells with most of them unable to travel through the vas deferens. To address this condition, doctors use a method called testicular sperm extraction, or TESE, to directly collect sperm from the testes.
Another method is the microscopic dissection of the testicles, also known as microTESE. As the name implies, the technique uses an operating microscope to examine the testicles and collect small tissue samples likely to contain sperm. Since microTESE considers more substantial portions of the testes, it is more invasive and requires general anesthesia. However, the technique allows for better sperm collection, even in men whose testicles produce very few sperm cells.
Choosing the Best Care
There are many ways to resolve male infertility surgically. Some methods focus on targeting conditions such as varicocele and mechanical obstruction, while others concentrate on bypassing infertility problems by obtaining sperm cells directly. Nevertheless, all of these procedures require a skilled surgeon to ensure the best outcomes for patients.
For people living in Phoenix, Arizona, reach out to the experienced medical team led by Dr. Desi Avila at Ironwood Urology and get the medical care you deserve. Call our office at (480) 961-2323, or use our online form to schedule an appointment today.