Small egg biopsy

Description:

Small egg biopsy – a method of surgical diagnosis and a stage of treatment of male infertility. Most often this operation is applied if the azoospermism is the reason of male infertility.

Azoospermism (from other - Greek ἀ-— absence, ζῷον — an animal and  — a seed) — morbid condition at which in an ejaculate there are no spermatozoa. The azoospermism is established by means of the analysis of an ejaculate (spermogram).

Types of a biopsy of a small egg:

Distinguish not obstructive (secretory) azoospermism at which in testicles spermatozoa, and an obstructive (excretory) azoospermism at which spermatozoa do not get to an ejaculate because of impassability of semyavyvodyashchy ways do not form. Also combined azoospermism connected along with hypofunction of testicles and disturbance of passability of semyavyvodyashchy ways is possible. The obstructive azoospermism (excretory infertility) gives in to treatment much better. Risk factors of an azoospermism are a genetic disorder, toxic influences (including alcohol, chemicals, radiation exposure), the inflammatory diseases of generative organs leading to disturbance of passability of deferent ducts, overcooling, avitaminosis, etc. The reasons of obstructive infertility – injuries, a vasectomy, operations for inguinal hernias, existence of inflammatory diseases of an epididymis or a prostate, malformations of deferent ducts, STD (gonorrhea).

1. PESA – percutaneous (through skin) aspiration (fence) of spermatozoa from an epididymis;
2. TESA – перкутання aspiration of spermatozoa from small egg fabric;
3. MESE – receiving spermatozoa when carrying out an open biopsy of an epididymis with the subsequent their extraction (fence);
4. TESE – receiving spermatozoa when carrying out an open biopsy of a small egg with the subsequent their extraction.

Aspiration (PESA, TESA) is carried out without section. The special aspirating needle with the syringe extracts the material (containing spermatozoa) respectively from fabric of a small egg or an epididymis.

The open biopsy (MESE, TESE) (see the drawing) is a small operation.
The procedure is carried out without serious consequences. At the request of the patient under the general or local anesthesia from low-traumatic access (the general anesthesia – in / венный an anesthesia is more preferable). The procedure to last 10 – 15 minutes. Skin of a scrotum is sewn up with a cosmetic seam. The biopsy is carried out permanently, but on the same day the patient can be allowed to go home or can is in a hospital 1-2 days. Seams do not need to be removed since the self-resolving threads are used.

Indications to a small egg biopsy:

1. An azoospermism (lack of spermatozoa in sperm);
2. A fence of spermatozoa for carrying out auxiliary reproductive technologies;
3. Suspicion of oncological diseases of a small egg;

Complications at a small egg biopsy:

There is a small  risk of bleeding or infection. On skin in the field of a biopsy of a small egg the inflammation later after the research can disturb you 2 – 3 days. The scrotum can swell or change color. It has to pass within several days after the procedure.

The best methods is – MESE and TESE (the biggest percent of pregnancy and childbirth). Besides, at TESE (an open biopsy of a small egg) a part of the taken fabric goes for the patogistologichesky conclusion. By means of this technique quality of a spermatogenesis is determined by a 10-mark scale of Johnson then it is possible to predict a possibility of carrying out operation on recovery of passability of seminiferous ways (epididimo-vazoanostomoz, vazo-vazoanostomoz, orkhi-vazoanostomoz), or to define a possibility of stimulation of a spermatogenesis by means of hormonal or non-hormonal techniques. It is proved that by means of a multifocal open biopsy of a small egg it is possible to receive single spermatozoa which can be used for artificial fertilization, even in cases of hyper gonadotropic secretory infertility (FSG is higher in 2 norms more time), at which was considered earlier that spermatozoa cannot be found in testicles.

After a small egg biopsy:

Within 10 days after operation restriction of an exercise stress, an exception of sexual contacts is recommended.

  The healthy spermatozoa received in such a way are frozen. Further they are used in  the IKSI program (an intracytoplasmic injection of a spermatozoon). IKSI is an extracorporal fertilization by introduction of one spermatozoon directly in an ovum ("probirochny fertilization").