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MESA procedure is an advanced male infertility treatment which is utilized with IVF treatment mainly in case of male infertility issues. If you are thinking how to increase sperm count, then you can opt for regular exercise and destress yourself, lose weight, take your vitamins, and avoid substance abuse.
Let’s Discuss in More Details About MESA:
- What is MESA (Micro-Epididymal Sperm Aspiration) Treatment?
- Cases Where MESA is Used?
- What is the Process of MESA?
- What are the Side Effects of MESA?
- What is the Success Rate of MESA?
- What are the Tips to Increase Sperm Count?
Microsurgical Epididymal Sperm Aspiration (MESA) is a relatively painless and minimally invasive procedure performed under local anesthesia. (1) MESA is a process of retrieving sperms containing fluid from optimal areas of the epididymis that are selected and sampled using high-power optical magnification. Retrieved sperms are used for ICSI (Intracytoplasmic Sperm Injection) to induce fertilization and pregnancy (2). MESA is considered to be a standard technique by many experts for sperm retrieval in men with obstructive azoospermia. MESA helps in yielding high-quality sperm, excellently reported fertilization, increased pregnancy rates and low risk of complications. However, MESA requires microsurgical skills and is only useful for reproduction using ICSI.
MESA is appropriate for men who have no sperm in the ejaculate because they are born either with novas deferens (the sperm-carrying tube) or have obstructive azoospermia (blockage). Some of the cases where MESA is recommended include (3):
- A patient who had a vasectomy (blocks or cuts each vas deferens tube, keeping sperm out of semen)
- If a patient has sexually transmitted infection like chlamydia
- In the case of retrograde ejaculation or anejaculation (unable to ejaculate).
- In case a patient had chemotherapy or radiotherapy and fertility has not returned to normal
- A genetic condition that affects fertility
- If a patient had his testicle removed (perhaps as part of cancer treatment)
- If a patient had surgery to bring down undescended testes
Often, poor sperm quality or a low sperm count is caused due to genetics but it can also occur as a result of a sexually transmitted infection, while in some other cases the cause remains unknown.
MESA is performed with the help of general anesthesia by the consultant urologist. During MESA, sperms are directly aspirated from a single, isolated epididymal tubule until 10–20 million are obtained. A detailed account of what follows in MESA is given as under:
- Firstly, a small cut is made in the scrotum to expose the epididymis (where sperms are stored) and then sperms are removed. The entire process is performed through an operating microscope.
- The epididymal tubules are opened and sperms are extracted. MESA allows surgeons to retrieve large numbers of sperms that may be frozen and utilized for future fertility cycles. This reduces the need for future procedures and limits the amount of epididymal scarring. Men who have undergone sperm extraction may also be candidates for a reconstructive epididymovasostomy (connection of the vas deferens and epididymis to bypass a blockage).
- When the aspiration is completed, the epididymal tubule is closed with multiple microscopic sutures and the scrotum is closed. (4)
The recovery period is approximately twenty-four hours. Sperms which are aspirated are processed and prepared for insemination with the eggs. MESA is routinely performed prior to IVF with ICSI cycle so that the couple can be assured that adequate sperms are extracted and are made available on the day of oocyte retrieval. The combination of the sperms extraction and surgical procedure increases the chances of sperms appearing in the ejaculate. Some patients may experience some discomfort in the groin for a few days after this procedure, which is completely normal, it can be treated with mild painkillers.
Side effects of this procedure are rare but bleeding and infection can occur. A small number of men experience a drop in their testosterone following surgical sperm retrieval, which may create problems related to sleep, muscle strength, sexual function, and anxiety. The risks of the procedure include damage to the epididymis, insufficient sperms, and bleeding. If this technique fails, sperms may be found using more advanced methods. Men with fertility issues are also more likely to develop testicular cancer, so it is very important to stay alert about the health status of the testicles regularly for lumps. (5)
Men who have undergone MESA for non-obstructive azoospermia, there is a 50 percent chance of sperm being successfully extracted. Chances are higher in case MESA is preferred for obstructive azoospermia. MESA is one of the most successful treatments for infertility followed by ICSI, which has reported fertilization and pregnancy rates between 45 and 52 percent. (6)
Male infertility factor affects about one in every five couples, and researchers estimate about one in every three cases is due to infertility problems in the male partner alone. The success rate of achieving pregnancy with a low sperm count varies based on the lifestyle changes. While infertility is not always treatable, it can sometimes be improved with lifestyle strategies, a healthy diet, and supplements. (7) Here are some of the tips to increase the sperm count:
1. Exercise regularly
Exercising improves physical performance and may also raise testosterone levels. Men who exercise regularly have higher levels of testosterone levels and better semen quality than men who do not exercise. (8)
2. Minimize stress
Stress can impair fertility and raises levels of cortisol, which has strong negative effects on testosterone. Unexplained anxiety can be typically treated with medication and milder forms of stress may be alleviated by numerous relaxation techniques. (9)
3. Lose weight
Studies have shown that weight loss can significantly improve the overall health of sperms. Men who have a higher body mass index have a significant sperm count. To accomplish weight loss goals, talk to a doctor who can help you get started. (10)
4. Take your vitamins
Vitamins such as vitamins D, C, E, and CoQ10, are important for boosting sperm count. Intake of 1,000 mg of vitamin C every day can increase men’s sperm concentration and mobility. According to a study, it is found that the rates of pregnancy among couples were higher among men with high levels of vitamin D. (9)
5. Avoid substance abuse
People with a history of heavy drinking, tobacco use, illegal drug use including cocaine and anabolic steroids have low sperm counts and unhealthy sperm.
MESA has significantly improved sperm retrieval rates in azoospermic men and is a safer procedure since less amount of testicular tissue is removed. Patients cryopreserve sperms during this procedure for future IVF or ICSI.
The use of non-ejaculated sperm along with ICSI (Intracytoplasmic Sperm Injection) has become a globally established procedure for couples with azoospermic male partners who wish to have biological offspring. The success rate of pregnancy from this procedure is reported to be 45 to 52 percent in selected IVF centers. It is a complex process, requiring significant manipulation of the eggs and sperms, but one which offers a previously sterile couple the chance of establishing a pregnancy using their own genetic material.
The first step in dealing with male factor infertility is consulting with a doctor who can help assess sperm count and analyze other fertility factors before making a plan for a possible treatment type in the future.
SOURCES AND REFERENCES:
- ^ Microsurgical Epididymal Sperm Aspiration (MESA) | CMRM Malereproduction.com, 17 June 2019
- ^ Intracytoplasmic Sperm Injection - Wikipedia En.wikipedia.org, 17 June 2019
- ^ Microsurgical Epididymal Sperm Aspiration: Indications, Techniques and Outcomes Ncbi.nlm.nih.gov, 17 June 2019
- ^ TESE/MESA Treatment Vivaneo-ivf.com, 17 June 2019
- ^ Success Rate of Pregnancy after MESA Publishing Knepublishing.com, 17 June 2019
- ^ How to Increase Sperm Count: Tips for Sperm Health - Healthline Healthline.com, 17 June 2019
- ^ The Impact of Intense Exercise on Semen Quality - NCBI Ncbi.nlm.nih.gov, 17 June 2019
- ^ Stress Degrades Sperm Quality, Study Shows - ScienceDaily Sciencedaily.com, 17 June 2019
- ^ Does Weight Loss Improve Semen Quality and Reproductive Hormones | NCBI Ncbi.nlm.nih.gov, 17 June 2019
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