While there’s plenty we don’t know, we have learned a lot about male fertility and reproduction over the past few decades. One of the most exciting areas of research and advancement has been in the management of male fertility concerns. Nonobstructive azoospermia was at one time considered difficult or impossible to treat, yet now, many men with no detectable sperm in their semen have become fathers. Today, there are several sperm extraction techniques available to these men, but most are invasive. As such, there has been a need for minimally invasive diagnostics to see whether sperm can be found in the testes.
This is where testicular mapping or FNA mapping comes into play. Testicular mapping is a highly effective, mildly invasive diagnostic procedure in which the testicles are mapped using fine needle aspiration. During the procedure, testicular tissue samples are removed and then analyzed to see if sperm is present. This has been a game-changer for patients that once only had the more invasive micro-TESE as their only option. The following information on testicular mapping should be of interest to men suffering from Azoospermia.
- We expect to find sperm in about 50% of men with azoospermia
- Over 30% of men are eventually able to become fathers as a result
- It’s a Less-Invasive, similarly effective diagnostic option versus a Micro-TESE
- It doesn’t reduce testosterone levels appreciably
- Only a few physicians perform it around the US
Why a Second Procedure?
Knowing that testicular mapping is purely a diagnostic procedure, why wouldn’t we just use a micro-TESE that allows for both diagnosis and treatment? The answer is simple. About 50% of men with nonobstructive azoospermia do not have viable sperm in the testes. Both testicular mapping and micro-TESE are very good at identifying patients with viable sperm, but the micro-TESE does so in a much more invasive manner. That means that about 50% of our patients will have an unnecessarily invasive procedure that inhibits their lives and lifestyles and may even cause longer-term low testosterone.
Will It Hurt?
One of the best qualities of testicular mapping is how minimally invasive it is and how little the procedure hurts. To be sure, there will be some discomfort after the procedure as the anesthetic wears off. However, anesthesia is administered during the procedure, and patients do not feel appreciable discomfort. On the other hand, a micro-TESE can cause significant discomfort during the recovery period.
Is Micro-TESE a Bad Procedure?
While the above discusses the downsides of a micro-TESE versus testicular mapping, understand that these limitations are only in the diagnostic realm, and that is why Dr. Kapadia is one of the few urologic surgeons around the country to offer testicular mapping. However, as a sperm extraction procedure (something that testicular mapping cannot do), micro-TESE is the gold standard. If we know there is viable sperm in the testes, a micro-TESE is the most effective way to extract it and help our patients become fathers.
In short, working with Dr. Kapadia to optimize a diagnostic and sperm extraction plan can save time and discomfort in appropriate patients. Dr. Kapadia sees azoospermia patients from all over the southeast United States, and we look forward to scheduling a consultation with you to learn more about the diagnostic options that you may have.