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Microsurgical epididymal sperm aspiration (MESA) refers to the process of obtaining immature sperm cells from the epididymis (a tube that connects a testicle to a vas deferens in a male reproductive system) in cases where obstruction in the genital tract results in the absence of sperm in an ejaculation.
MESA is considered the gold standard technique for sperm retrieval in men with epididymis or vasal obstructions. This process provides a high yield of quality sperm and has a low risk of complications. The pregnancy rate using this technique is excellent. It requires microsurgical skills and is only useful for reproduction using ICSI.
MESA is carried out under general anesthesia. A slit is made in the skin of the scrotum and the testicle is exposed. An operating microscope helps the surgeon to see the epididymis under magnification. Sperm movement is observed in the fluid from the epididymis and the fluid is taken for immediate use or frozen for future use.
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