Wednesday, November 18, 2015

Mapping for sperm

Sperm production within the testis can be haphazard and sporadic.   The absence of sperm in one area does not mean that sperm will be absent in another area.   This fact has important implications for men with azoospermia who require sperm retrieval procedures. 
Where is the best place to look for sperm within a testicle?

Answer: depends and varies case by case.  

There are 2 strategies that urologists employ to maximize sperm retrieval rates in men with non obstructive azoospermia: the mTESE and the TFNA mapping.  Both have advantages and disadvantages.  I have adopted the mapping as my first step.   It allows me to determine if sperm is present and where in an efficient and minimally invasive way PRIOR to committing the man to an invasive sperm retrieval procedure and the woman to IVF.   When I find sperm on a mapping I can then proceed with confidence to the next step, the TESE.   If I don't find sperm on a mapping, then I recommend mTESE