Microdissection testicular sperm extraction (micro-TESE)

In this surgical procedure, the testicle is opened under an operating microscope in a manner that exposes most of its internal contents allowing your surgeon to look for tubules that look “promising” and are more likely to have sperm inside of them. This surgical technique typically yields a higher rate of successful sperm retrieval in patients with non-obstructive azoospermia and therefore is the sperm recovery surgery of choice for these patients. It has also been shown to have relatively minimal impact on the testosterone production ability of the testicle. The sperm found during this procedure is always used for intracytoplasmic sperm injection (ICSI), a form of in-vitro fertilization. Given the sperm recovered is usually a limited amount and they have not learned how to swim yet, other forms of assisted reproduction techniques are not possible. Dr. Clavijo has extensive experience performing this surgery under the microscope.

Microsurgical epididymal sperm aspiration (MESA)

In this surgical procedure the epididymis is incised under the microscope at several strategic locations   in order to recover moving sperm. In ideal candidates this surgery can yield thousands and even millions of moving sperm (e.g. patients with obstructive azoospermia). Typically, enough sperm for several cycles of IVF can be recovered.

Testicular sperm aspiration (TESA)

This procedure is typically done in the office setting under local anesthesia. After the testicle is numb a small needle is passed several times into the testicle in order to draw out sperm. Ideal candidates are those diagnosed with obstructive azoospermia or patients who are not able to provide a semen sample for some reason but are still thought to make a normal amounts of sperm. The sperm from this procedure is typically used for IVF cycles.

Transurethral Resection of Ejaculatory Ducts (TURED)

This surgery is performed on patients diagnosed with partial or complete ejaculatory duct obstruction. With the patient under complete anesthesia Dr. Clavijo uses an electric loop typically used for prostate surgery and makes an incision in the area of the prostate where the ejaculatory ducts are in order to relieve the obstruction. This is typically done using transurethral endoscopy (a camera in the urethra) with no incisions made in the skin. This surgery can improve passage of sperm during ejaculation.

Dr. Clavijo performs sperm retrieval surgeries at California IVF Fertility Center in Sacramento as well as at UC Davis Medical Center. For up-to-date prices or questions please feel free to email Dr. Clavijo at riclavijo@ucdavis.edu.