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Monday, July 07, 2008

5 questions to ask your urologist prior to a sperm retrieval

TESE, or testis sperm retrieval, can find sperm in the most challenging of male infertility cases. Here are some answers to some common questions from patients of mine.
  1. Can I do IUI with sperm retrieved from a TESE? In general no. Not enough sperm is typically found nor does the sperm have adequate motility to be useful for IUI.
  2. Should a TESE be done in coordination with my IVF procedure? Answer: it depends. In cases of known blockages in the man, such as after a vasectomy, cryopreserved and thawed sperm works just as well as freshly harvested sperm. In cases where the cause of the azoospermia is unclear, I believe that fresh sperm provides the best chances for a successful outcome.
  3. Is TESE covered by insurance? Sometimes. The problem is that the AMA has not come up with a CPT code (billing code) for a TESE. This makes it difficult to get pe-certs from insurance carriers in many cases.
  4. Will sperm from a TESE be healthy? Yes. Sperm from a TESE works just fine and can fertilize eggs and create healthy embryos.
  5. Can you guarantee you'll find sperm? Maybe. In cases of known obstruction, the likelihood of finding sperm is 99%. In cases of testis failure, that success can be as low as 20%, but is usually in the 50% range.