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Return to Surgery Helps Men Thought To Be Sterile Become Fathers Overview

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Surgery Helps Men Thought To Be Sterile Become Fathers

NEW YORK (Feb 3, 2014)

It is estimated that about 1% of the male population has severely impaired sperm production, so low that there are no sperm seen on a semen analysis, thereby affecting their ability to father children. Thanks to a special surgical procedure, known as microdissection testicular sperm extraction (microTESE), men who were once considered sterile can now become fathers.

Peter N. Schlegel, M.D.
Peter N. Schlegel, M.D.

"It turns out that some men with low sperm production actually have tiny pockets of sperm located in tissues in their testicles. With the microTESE procedure, we are able to operate in the testicle, find sites of sperm production and carefully remove sperm," explained Peter N. Schlegel, M.D., who pioneered the surgical technique and first published results from 20 patients in 1999.

Since then, Dr. Schlegel and colleagues have treated about 1,700 patients with the TESE procedure. His group has carefully refined the innovative surgical technique over the years. "We have treated enough patients at this point that we can identify which patients will have a high chance of success," he said.

During the procedure, doctors use an operating microscope to help identify the internal structures and areas of the testicle that are the most likely to contain sperm. "We don't have to do a random biopsy. We perform very focused removal of tiny amounts of tissue and carefully remove individual sperm," explained Dr. Schlegel. After the sperm are retrieved, they are immediately injected into eggs that were clinically removed from women in order for pregnancy to occur. The fertilization procedure is known as intracytoplasmic sperm injection (ICSI).

Typical candidates for microTESE-ICSI treatment are men who are deemed sterile for a number of reasons including low sperm production, damage from previous cancer treatment, injury to the reproductive tract, or genetic conditions. Dr. Schlegel initially began performing the microTESE procedure in male cancer survivors but he noted that the majority of his patients now are men with low sperm count. Most patients are in their early 30s, but he treats men as young as their 20s. Patients return home from the hospital the same day and there is only a small risk associated with the procedure.

Although microTESE is being performed at many centers of excellence, physicians from other centers often come to NYP to learn and observe Dr. Schlegel's group. "Sperm retrieval depends on the fine details of the procedure and is a large team effort. Our pregnancy rates are substantially better than most rates throughout the world," said Dr. Schlegel.

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