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MESA for

When You Offer What Very Few Centers in the World Can In male infertility, it’s easy to repeat what’s been done before. But in complex cases, repetition is rarely progress. Recently, in New Delhi, India, I saw a 40-year-old couple from Sudan. The husband had obstructive azoospermia and they had already endured three failed IVF cycles using TESA. Most would suggest another TESA, perhaps with minor modifications. Instead, we took a path that requires rare microsurgical training, precision, and confidence: We performed a combined MESA (Microsurgical Epididymal Sperm Aspiration) with VEA (Vasoepididymal Anastomosis) — a surgical pairing that only a handful of advanced centers worldwide can offer. Why this matters: Mature, higher-quality sperm from MESA increases the odds of IVF success compared to repeated TESA. VEA reconstruction restores the natural sperm pathway — creating a chance for spontaneous conception years later. Dual benefit, single surgery: Both immediate ART success and long-term natural fertility potential. Minimizing repeat interventions: Reducing the patient’s exposure to multiple retrieval surgeries. This is the kind of work where reproductive surgery, laboratory science, and patient vision align perfectly. It’s not just about performing an operation — it’s about expanding what’s possible for the patient and setting a new benchmark for care. Advanced male infertility surgery is not common because it demands a unique blend of surgical expertise, embryology coordination, and case selection. But when done well, it changes everything. — Dr. Vijayant Govinda Gupta Andrologist & Microsurgeon | Male Infertility & Advanced IVF Surgery New Delhi, India #MaleInfertility #Microsurgery #Azoospermia #IVF #Andrology