IVI has used this technique for years in the clinics located in Madrid and Valencia, and it aims to progressively implement it in all the remaining IVI clinics. A total of 23 biopsies were performed in 2016 alone. Sperm were successfully retrieved in 56.52%, which involves 13 positive Micro-TESE surgeries. Six of the cases resulted in pregnancies after undergoing IVF cycles with microinjection of the recovered sperm.

According to the urologist of the IVI clinic in Madrid, Dr Carlos Balmori, “the surgical microscope helps improve visibility and extensive visualisation of testicular tubules, to select the most adequate sample of testicular tissue. Micro-TESE is an alternative to random biopsies that have been typically used. It helps minimise tissue damage as compared with open biopsies, allowing a more selective surgical process. With conventional biopsies, a significant amount of testicular tissue is extracted, which may impact the production of testosterone, one of the main functions of the testicles. Testicular tissue does not regenerate; we should be cautious when retrieving it in order to avoid the development of hypogonadism, for example”.

IVI is one of the few clinics in Spain that performs surgical sperm retrievals with Micro-TESE, as among others, it requires a sophisticated set up and infrastructure, states Dr Saturnino Luján, urologist at IVI Valencia: “it requires microsurgical expertise, which involves a skilled team of urologists and biologists. Once obtained, the sperm can be frozen for future in-vitro treatments or used directly, without freezing”.

Once more, IVI keeps a step ahead assisted reproduction treatments and offers its expertise to the patients. Although Micro-TESE appears to be a revolutionary surgical approach for sperm retrieval, Dr Balmori points out “ideally, enhanced visual magnification would help visualise directly the sperm cells. Improvements in image-capture devices are being made to easily view the tubules that contain sperm”.

Hypogonadism

It is a disorder that is associated with deficiency of the gonads, ovaries and testicles, as they do not receive proper signals from the hypophysis, maybe because it does not function properly or because there is a problem in the hypothalamus to stimulate the production of hormones. This condition results from brain injury after surgery or infections, or from genetic disorders.

Azoospermia

Azoospermia is the name given to the condition in which there are no sperm in the ejaculate. There are two types of azoospermia: obstructive azoospermia, which is caused by a blockage or surgery, and non-obstructive or secretory azoospermia.