MESA in ICSI

Microsurgical Epididymal Sperm Aspiration is a minimally -invasive advanced surgical procedure employed in the reproductive medicine arena. The procedure is recommended for men who are diagnosed with ejaculatory duct obstruction (EDO). The surgical procedure is completely safe and takes just 10-15 minutes. It is an outpatient procedure, and individuals need to undergo general or local anaesthesia. It is either performed on an appointed schedule or in coordination with their spouse’s egg retrieval.

MESA is a small surgical procedure performed by a microsurgeon. It is conducted through a small incision in the skin of the scrotum to expose the testicle and the epididymis. The surgeon uses an operating microscope to examine tiny tubes in the epididymis and carefully extract sperm. To stimulate fertilisation and pregnancy, the obtained sperm is injected directly into the partner’s egg via a method known as intracytoplasmic sperm injection, or ICSI.

Intracytoplasmic sperm injection is most often performed in cases where sperm is surgically extracted through MESA or other sperm retrieval techniques. Mesa in ICSI improves the chances of pregnancy even with low sperm quantity. Under this procedure, a single sperm is injected into the egg. Your reproductive endocrinologist employs a pipette to hold the egg. They select single sperm using a tiny needle. Sperm is then gently inserted through the egg’s outer shell and into its cytoplasm. After the ICSI procedure, the doctor examines the egg for successful fertilisation. If the egg begins developing normally, the doctor will inject the embryo into your uterus. After 2 weeks, your doctor may advise you to go for a pregnancy test.

Recovery after MESA can take anywhere from a few days to a week. It may vary based on your general health, and most men can return to work within 24 to 48 hours. However, intensive work should be avoided for at least 10 days.

• Men should refrain from strenuous activities for a few days.
• The patient should take their medications on a regular basis, as prescribed.
• Rarely, however, experiencing bleeding, pain, and infection is possible.

Who Benefits from ICSI?

The partners or individuals suitable for ICSI include the following.

• Men with very low or no sperm count
• An obstruction in the male reproductive canal stops sperm from being expelled.

ICSI treatment, as well as the MESA technique, is typically painless. A minor incision to the epididymis under local anaesthesia is needed. However, some people may experience minor discomfort or cramping subsequently.

The success of the microsurgical epididymal sperm aspiration in ICSI is entirely dependent on the particular patient and their medical condition. Regardless, research reveals that 50% of people can conceive after just one round of ICSI with epididymal sperm.  The surgery should be viewed as a technique to relieve sperm in a patient where no sperm is present in ejaculate, not as a guarantee of pregnancy.