Percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE) are techniques used when a man presents with no sperm in his ejaculate but still produces sperm in his testes. This may occur due to:
- A vasectomy
- A congenital (present at birth) obstruction of the sperm ducts leaving the testes
- Inadequate development of the sperm such that they cannot leave the testes
In these situations, a urologist can remove sperm by placing a needle into the testes or the tubes that drain it and remove the sperm at that location. These procedures are done under anesthesia and can be very effective when combined with ICSI. Occasionally, a urologist will use a testicular biopsy for sperm extraction with what is known as microdissection—using a microscopic examination of the testicular tissue to identify viable sperm.
RMIA partners with Dr. Aaron Milbank from Metro Urology to perform TESE’s on-site at RMIA. Micro-TESE’s are performed at HighPointe Surgery Center.
Dr. Aaron Milbank attended medical school at Cornell University in NYC. After graduating from medical school, he completed a six year residency in Urology and Urologic Surgery at the Cleveland Clinic in Cleveland, OH. It was during his residency that Dr. Milbank became interested in male infertility issues and microsurgery. Following his residency, Dr. Milbank completed a formal fellowship in Male Infertility and Microsurgery at the Cleveland Clinic. After completing his fellowship in 2005, Dr. Milbank joined Metro Urology where he has established his practice of male infertility.