Microdissection testicular sperm extraction (m-TESE)

The problem of infertility has always accompanied the human species, it occurs globally, regardless of race or place of residence. According to the WHO, this applies even to every 6th couple seeking pregnancy, and the share of the male factor reaches 50%. The development of assisted reproductive techniques: insemination (1790) or performed almost two centuries later in vitro fertilization procedure – IVF (1978), gave birth to many struggling couples. Despite these achievements, infertility compounds with the dominant male factor, where sperm was absent in semen, remained an unsolvable clinical problem for years. Since the introduction into human reproduction medicine in-vitro fertilization with injection into the oocyte male generative cell – ICSI (1992), sperm obtaining techniques have devel­oped from patients with azoospermia. Described in 1998, a testicular biopsy using an operating microscope – microTESE (m‑TESE), proved to be the most effective surgical procedure in this regard and enabled the inclusion in reproduction of next group of infertile men, previously disqualified due to azoospermia. The author presents personal experience in performing testicular biopsies using an operating microscope, carried out in one infertility center since 2012.