June 26, 2025
In recognition of Men's Health Month in June, Mayo Clinic Urology is proud to spotlight a new clinical trial aimed at improving outcomes for men with obstructive azoospermia. Spearheaded by principal investigator Sevann Helo, M.D., a urologist at Mayo Clinic in Rochester, Minnesota, this trial compares two standard sperm retrieval techniques — testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA) — in the setting of in-vitro fertilization (IVF).
Removing barriers to fertility care
As a leading specialist in male infertility and office-based urologic surgery, Dr. Helo is a national advocate for making fertility care more accessible and affordable. In an area of medicine often burdened by high out-of-pocket costs and insurance exclusions, she has pioneered minimally invasive, in-office surgical techniques that help reduce the financial strain on patients and improve access to timely care.
"Fertility shouldn't be a luxury," says Dr. Helo. "Our goal is to offer the same high-quality procedures in a more cost-effective and patient-friendly setting, especially for couples who are already navigating the emotional and financial complexities of infertility."
Her leadership in this trial reflects that philosophy: combining rigorous clinical research with a pragmatic approach to patient-centered care.
About the trial
The clinical trial focuses on patients diagnosed with obstructive azoospermia, a condition in which sperm are produced but cannot reach the ejaculate due to a blockage — most commonly from prior vasectomy. In such cases, assisted reproductive technologies such as IVF are essential, but the route to obtaining viable sperm can vary.
This trial directly compares TESE and MESA, two commonly used retrieval techniques, by performing both procedures during a single operative session using local anesthesia. This allows for intrapatient comparison without added procedural burden or increased cost.
Eligible participants must:
- Be 18 years or older.
- Have a diagnosis of obstructive azoospermia.
- Be planning IVF treatment with a partner.
The study involves three visits: a combined TESE-MESA procedure visit and two follow-up appointments to monitor for postprocedure effects. Participation continues for up to two years or until IVF results in a live birth. Importantly, the study does not impact IVF success rates or increase treatment costs and is conducted solely to advance scientific understanding.
Why it matters: Men's Health Month spotlight
Male factor infertility plays a role in nearly 50% of infertile couples, yet it remains an underrepresented issue in public discourse and medical research. This clinical trial aligns with the goals of Men's Health Month: to raise awareness, reduce stigma, and empower men to take an active role in their reproductive and overall health.
By generating data on the comparative effectiveness of two established sperm retrieval approaches, this study aims to:
- Improve evidence-based fertility care.
- Inform surgical decision-making.
- Help more couples pursue IVF with confidence.
Bridging research and real-world impact
Dr. Helo's commitment to high-impact, low-barrier fertility care is central to this work. Her innovative focus on office-based microsurgical procedures not only enhances patient comfort and convenience but also supports health equity by expanding care to a broader patient population.
She emphasizes collaboration across specialties — working closely with reproductive endocrinologists, primary healthcare professionals and other urologists — to ensure that patients are evaluated thoroughly and offered the full range of fertility-preserving options.
For more information
Clinical trials: Epididymal and testicular sperm for in-vitro fertilization. Mayo Clinic.
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