Assoc. Prof. Dr. Rumen Dimitrov – Chief embryologist of clinic \“New Life\“ speaks about the TEFNA method
What is the difference from the standard testicular biopsy and TEFNA in embryological point of view?
From the embryological point of view the difference between the standard testicular biopsy and TEFNA is that with tefna the material processed in the embryological laboratory makes it easier to find and isolate motile sperm. In connection with this, the procedure, although long ,as the isolation of sperm in a standard way of testicular biopsy, tefna allows us to easier find and isolate motile sperm. This gives a chance for a higher percentage of fertilization, since it is desirable to inject motile sperm after tefna.
Why Tefna, Assoc. Prof. Dimitrov?
From a clinical point of view it is defined as noninvasive method for men, who need tefna or similar procedures i.e. testicular biopsies, these are men who have very serious problems with sperm production. In recent years, it is found that even in men who have very severe abnormalities, including genetic, which halt spermatogenesis, there is a chance in individual focal areas that it is preserved as a process. Since spermatogenesis takes place in many tubules in the testis, it was found that even at very serious breaches in some of the ducts that process still exists. Thus by Tefna when suctioning tubules from multiple channels there is a greater chance to find a place where the process is still functioning, and thus in embryological laboratory enters a material that is not as rich in texture as rich tubules, in which there are sperm that easily after machining can be isolated. This does not require the use of enzymatic treatment that would be problematic, since it uses preparations of animal origin, which is not acceptable in human medicine.
Does the entire testicle is tested at Tefna or as in a standard testicular biopsy (narrow) only part of the testicle?
Depends on the case, in most cases, both testicles are biopsied from several locations , but because it is done with a very fine needle and does not actually take tissue from the testicle itself, as in a standard biopsy and aspirate with this needle exactly the part where spermatogenesis is done, it allows to be done in more places than a standard procedure. Accordingly, in embryological laboratory there is a better chance , more material enters that is more in terms of what has been taken from more locations, but otherwise as quantity there is no tissue that prevents us from finding sperm.
What is it like working with prof.Neri Laufer and Dr. Anat Safran?
In Israel this method is introduced exactly by prof.Neri Laufer and Dr. Anat Safran which gives us a guarantee that we use a lot more sophisticated and new validated method TEFNA that is much more painless and spares the patient from classical testicular biopsy. And the results can not be compared – between the two undoubtedly Tefna is the future of the testicular biopsies throughout the world.