Our success rate is about 60% among patients with production failure
- Dr. Berookhim is one of few surgeons with fellowship training and robust experience in the performance of microTESE. In patients where they have azoospermia/zero sperm count due to a failure of production, whether or not a genetic factor is identified, we are often able to identify pockets of sperm production within the testicle that can then be used as part of an IVF cycle.
Success rates, in terms of finding sperm, are variable depending on the underlying diagnosis, but are around 60%. All urologists, and even all fertility focused urologists, cannot and do not necessarily perform this surgical treatment. This means that even patients who have undergone previous failed attempts at surgical sperm retrieval at less experienced centers will have a real chance at finding sperm within the testicle for use with IVF.
We have participated in a study on this and have helped publish rigorous data on this in one of the premier fertility journals, Fertility and Sterility. For more information, please see:
Berookhim, Boback M et al. “Microdissection testicular sperm extraction in men with Sertoli cell-only testicular histology.” Fertility and sterility vol. 102,5 (2014): 1282-6. doi:10.1016/j.fertnstert.2014.08.007
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349348/
We have also published an in depth textbook chapter on the management of patients presenting with azoospermia/zero sperm count . For more information, please see:
Berookhim, Boback M, at al. “Azoospermia due to spermatogenic failure.” The Urologic clinics of North America vol. 41,1 (2014): 97-113. doi:10.1016/j.ucl.2013.08.004
How is microTESE performed?
In this surgery, the patient receives general anesthesia, and an incision is made in the scrotum to gain access to the testicle. The testicle is then opened, and with use of an operating microscope under 20x magnification, we sort through the underlying testicular tissue to attempt to find pockets where sperm production is available within the testicle. This tissue is then removed and is analyzed by our embryologists and andrologists, who sort through the dissected tissue to attempt to find and freeze sperm. The surgery can take from 1 to 4 hours as dissection is continued throughout the testicle until sperm is either identified or the entire testicle (or both) have been evaluated.
What are the benefits of microTESE?
microTESE gives men with azoospermia a chance for biological fatherhood if sperm production can be identified within the testicle.
What are the risks of microTESE?
Unfortunately, a percentage of patients will fail to have sperm identified within the testicle. Other risks include a small risk of long term testosterone deficiency, pain, bleeding and infection.
Is it covered by insurance?
Insurance coverage for microsurgical vasectomy reversal is variable and depends on your plan benefits. Our office will work closely with your insurance carrier to determine eligibility. In patients where this is not covered, we will work with you to best determine how to proceed.
Why Mens Health Manhattan: Microdissection Testicular Sperm Extraction
At Men’s Health Manhattan, we are one of the premier centers in New York with fellowship-trained, subspecialty expertise in the management of male factor infertility and subfertility. We work closely with and have long-standing, direct relationships with a number of the larger in vitro fertilization (IVF) and female fertility centers in New York. As the management of fertility is a team effort, these relationships foster direct and frequent communication between our center and the IVF teams and generally help to lead to better overall outcomes.
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