Saturday, 27 April 2013

interesting case yesterday!
the couple were married since the last 10 years and the female partner had to undergo a hysterectomy dues to Multiple big fibroids which were not regressing with medication or with Minimally invasive surgery.
the male partner is azoospermic with a low FSH reading so we put him on Injection HCG 5000 units/week for 12 weeks.
the Egg and sperm extraction for both partners was done yesterday.
the sperm extraction was done  by Testicular biopsy which is a minor surgery to remove a piece of tissue from the testicles for examination under a microscope.The skin over the testicle is cleaned with normal saline instead of antispetic as this may damage the sperm. The area around it is covered with a sterile towel. A local anesthetic is given to numb the area.
A small surgical cut is made through the skin, and a small piece of the testicle tissue is removed. A stitch is used to close the opening in the testicle. Another stitch closes the cut in the skin. If necessary, the procedure is repeated for the other testicle if sperm is not found from one side.
initially there was no motility found and all the sperms looked immotile.
after performing a density gradient wash there was still no motility,hence i added a litle bit of Media which provides nutrition to the sperm and kept it in the incubator for 3 hours.
after 3 hours motility was seen and ICSI was done.