Men’s Health

Sperm Extraction in Cleveland, OH

Microsurgical Testicular Sperm Extraction

Men who have azoospermia, a condition where no sperm comes out during ejaculation, may require a microsurgical testicular sperm extraction in order to harvest sperm.  Dr. Thirumavalavan is specially trained in microsurgery and microsurgical testicular tissue extraction. He has extensive experience performing this procedure at his offices throughout Cleveland, Beachwood, and Lyndhurst, OH. Call (216) 285-5036 to schedule an appointment today!

Nonobstructive Azoospermia (NOA)

Nonobstructive azoospermia (NOA) is diagnosed when a man has zero sperm seen on a semen analysis, and when there are abnormalities in his male reproductive hormones such as testosterone.

What are the Causes and Symptoms of NOA?

There are a few genetic conditions and abnormalities that cause men to not be able to produce enough sperm. Prior to undergoing surgery, we will test you for these genetic conditions, and in some situations have you meet with a genetic counselor to further discuss the implications.

NOA Treatment and Sperm Extraction

Testicular Tissue Extraction

The treatment options for non-obstructive azoospermia include a testicular tissue extraction with or without a microscope. Dr. Thirumavalavan uses the newest in surgical microscope technology to ensure optimal visualization and a higher chance of success. The use of the microscope increases the chance that we find sperm and decreases the complication rate after the procedure. In this procedure, after you go under anesthesia, we open the testicle and look for sperm under a microscope, to find small areas of sperm production. Small pieces of testicular tissue are removed, and the testicular tissue is examined for sperm cells by the embryologist in the fertility laboratory.

If sperm cells are found, the tissue is frozen for potential future use in infertility treatment. Because of the relatively few sperm obtained using TESE, these sperm need to be combined with the wife’s eggs in the lab using in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI).

Procedure Results

In patients with nonobstructive azoospermia (spermatogenic failure), several biopsy specimens may be needed from each testis in order to find areas of active spermatogenesis. This can usually be performed through one small incision on each side of the scrotum. In the nonobstructed testicle, approximately 50% of patients will have some sperm obtained by TESE.  Pregnancy rates ranging between 30-50% per ICSI cycle have been reported for patients with nonobstructive azoospermia.

Procedure Recovery

You will have stiches and skin glue on your incision(s). The stiches will dissolve on their own. You will go home with an athletic supporter and gauze for comfort. At home, use the supporter until the swelling goes down. Some discomfort and swelling in the area of incision and in the groin/testicles are not unusual and should improve within 1 -2 weeks. Strenuous exercise (for example, climbing ladders, riding motorbikes or bicycles, playing tennis, lifting more than 10lbs, etc.) should be avoided for 2 weeks after your procedure. Engaging in these activities can increase your risk of complications.

We will see you in 2 weeks after your surgery, to check on your wound. Subsequently, you will have a sperm analysis in 3 months, as it takes that long to see improvements in sperm counts after varicocele repair.

Schedule an Appointment

Dr. Nannan Thirumavalavan is a board-certified urologist specializing in male infertility and microsurgery.  He has extensive experience performing Microsurgical Testicular Sperm Extraction in order to help men and their partners conceive. Call (216) 285-5036 to schedule an appointment today!


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