MESA is a treatment used to treat males with vasal or epididymal blockage (s/p vasectomy, congenital bilateral vas deferens absence). It is either done on a scheduled basis or in conjunction with the egg retrieval of their female spouse. MESA is done under general anaesthesia in the operating room with the use of an operating microscope. During this technique, patients commonly cryopreserve sperm for future IVF/ICSI. When opposed to aspiration procedures, MESA provides for a more comprehensive collection of mature sperm, and it is the recommended method of retrieval for males with congenital bilateral absence of the vas deferens since it does not affect testis steroid production.

How is MESA carried out?

Let us now look into how MESA is carried out. A small needle is inserted from the scrotum to the epididymis during microsurgical epididymal sperm aspiration. After that, the epididymis is dissected with the use of an operating microscope. When the epididymis tubules are incised, the fluid flows out and collects in the epididymis bed. 

This fluid is then aspirated and delivered to the laboratory for sperm extraction. The sperm discovered are utilised in the IVF ICSI technique. The ductule is closed once the sperm are removed. A new ductule is resected if no sperm are discovered. MESA sperm can be cryopreserved for future IVF ICSI efforts if a high amount of sperm are recovered.

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