Sperm Mapping + ESSM = FFN-TSA
Aspirating sperm directly from the testes with fine needles.
We have recently pioneered the use of combining the diagnostic value of the sperm mapping procedure with the therapeutic value of collecting sperm at the same time. We have termed this Field Fine Needle Testicular Sperm Aspiration or FFN-TSA.
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How is this Procedure Performed?
For traditional Sperm Mapping, a grid or “map” is drawn on the scrotal skin, and sequential needle aspirates/biopsies taken from each of the marked locations. Each one is placed on a separate slide labeled with the location from which it was taken. The slides are all sent to a pathology lab, to see if there are any sperm and if so how many sperm there are on each slide. This determines if there are any sperm in the testis at all. It also provides a road map as to where to find sperm, when a more invasive procedure is used to actually procure them, for use with IVF/ICSI.
The sperm would then traditionally be procured using an invasive procedure called a micro-TESE. However, the roadmap provided by the sperm mapping sometimes allows us to do a less invasive large needle biopsy in the area where sperm were found on the mapping. (See Published Abstract) In all cases, a sperm mapping is thus solely a diagnostic procedure, and if sperm are found, a second more invasive procedure is needed to procure it.
This new procedure basically combines a sperm mapping with an Extended Sperm Search & Microfreeze (ESSM). The sperm aspirates from each location are placed into sperm friendly fluid, rather than on a slide. The aspirates from one side are combined and then examined using ESSM. Any sperm found, rather than killed by being placed on a slide, are isolated and frozen, for future use.
Thus, in one dramatically less invasive procedure, we are not only diagnosing whether there are sperm in the testicles but procuring them for use with IVF/ICSI simultaneously.
Who Should Have this Procedure?
If a man is diagnosed with azoospermia, we recommend he undergo a non-invasive lab test called an ESSM. In 44% of azoospermic patients, sperm have been found and successfully frozen using this procedure.
In the past, if no sperm were found with an ESSM, we would have recommended a sperm mapping or micro-TESE, the latter of which is quite invasive and can ultimately damage the testes.
However, we are now able to offer this new option, called FNN-TSA, which combines two minimally invasive procedures, resulting in successful sperm extractions. We recommend it for men who have not been successful with an ESSM alone.
What’s Different About Maze?
Michael A. Werner, M.D., FACS is a board-certified urologist who received his specialized fellowship training in male infertility and surgery. He has diagnosed and treated thousands of men with infertility issues since 1994. Dr. Werner takes the time needed to uncover the underlying causes of your infertility so that all potential options are available to you. He is the only Infertility Specialist in the U.S. offering the innovative ESSM procedure. He also pioneered a brand new dramatically less invasive sperm extraction procedure called FNN-TSA, which combines sperm mapping and ESSM and is showing great promise for many couples.
The bottom line is that Dr. Werner is passionate about helping couples have children and he will continue to perfect existing techniques, as well as seek new options to accomplish this goal for all of his patients.
Last updated: August 2023