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T.E.S.E and ICSI

Testicular sperm extraction (T.E.S.E) is a technique that can be used to obtain a small amount of testicular tissue and is actually a surgical biopsy of the testis under local anesthesia. It is a revolutionary procedure, given that sperm doesn’t have to mature and travel through the epididymis in order to fertilize an oocyte. However, due to sperm immaturity, testicular sperm is used with ICSI.

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Testicular sperm extraction (T.E.S.E) is recommended for patients with a blockage in the epididymis, very close to the testes (from previous surgery, infection or a genetic birth defect) or blockage in the ejaculatory duct.

It is also recommended for men with extremely poor sperm production, that there are not enough spermatozoa to reach the end of the reproductive tract. Currently, achieving pregnancy in cases of severe male factor infertility has become a routine. However, there is still concern about using testicular sperm since, in most cases, the etiology behind poor sperm production remains unknown.

Therefore, the application of ICSI in couples with severe male factor infertility can result in offspring with an enhanced risk of inheriting genetic abnormalities.

However, the use of immature germ cells in clinical practice has raised many concerns. It is, therefore, crucial to investigate the genetic stability of these cells on animal models.