/**
 * v1.0.4 - 05-04-2021 20:10
 *
 * JQuery UI Dialog Extended
 *
 * Copyright 2013-2015, Felix Nagel (http://www.felixnagel.com)
 * Copyright 2021, Team Updraft
 * Dual licensed under the MIT or GPL Version 2 licenses.
 *
 * http://github.com/fnagel/jquery-ui-extensions
 *
 * Depends:
 *	jquery.ui.core.js
 *	jquery.ui.widget.js
 *	jquery.ui.dialog.js
 *
 * Changes:
 *  Add "updraft-dialog" class for every jQuery UI dialog created by UpdraftPlus plugin.
 *  Wrap all "updraft-dialog" class with "updraft-container" class
 *   to prevent CSS conflict with other plugins that use jQuery UI too.
 */
(function( $ ) {

/*
 * Option width and height normally set the overall dialog dimensions.
 * This extensions make these options the dimensions of the content pane if
 * option useContentSize is enabled. This way it's possible to set the real
 * content dimensions.
 *
 * Please note you won't get the original size but the calculated overall size
 * when using the width and height option getter.
 */
$.widget("ui.dialog", $.ui.dialog, {
	options: {
		height: 200, // auto is not allowed when using animation

		closeModalOnClick: true,
		dialogClass: 'updraft-dialog',

		// viewport settings
		forceFullscreen: false,
		resizeOnWindowResize: false,
		scrollWithViewport: false,
		resizeAccordingToViewport: true,
		resizeToBestPossibleSize: false,

		// width and height set the content size, not overall size
		useContentSize: false,

		// animated options
		useAnimation: true,
		animateOptions: {
			duration: 500,
			queue: false
		},

		// callbacks
		resized: null
	},

	// Changes content and resizes dialog
	change: function(content, width, height, animate) {
		if (typeof animate !== "boolean") {
			animate = this.options.useAnimation;
		}

		if (animate) {
			this.setAriaLive(true);
			this.element.one(this.widgetEventPrefix + "resized", this, function(event) {
				event.data.element.html(content);
				event.data.setAriaLive(false);
				event.data.focusTabbable();
			});
		} else {
			this.element.html(content);
		}

		this.changeSize(width, height);
	},

	// Changes size
	changeSize: function(width, height) {
		this._setOptions({
			width: width,
			height: height
		});
	},

	_setOption: function(key, value) {
		if (key === "width") {
			this._oldSize.width = value;
		}
		if (key === "height") {
			this._oldSize.height = value;
		}

		// we need to adjust the size as we need to set the overall dialog size
		if (this.options.useAnimation && this.options.useContentSize && this._isVisible) {
			if (key === "width") {
				value = value + ( this.uiDialog.width() - this.element.width() );
			}
			if (key === "height") {
				value = value + ( this.uiDialog.outerHeight() - this.element.height() );
			}
		}

		this._super(key, value);
	},

	// calculate actual displayed size, data contains already the overall dimensions
	_getSize: function(data) {
		var options = this.options,
			feedback = $.position.getWithinInfo(options.position.of),
			portrait = ( feedback.height >= feedback.width ) ? true : false,
			viewport = {
				width: feedback.width - ( this.uiDialog.outerWidth() - this.uiDialog.width() ),
				height: feedback.height
			};

		if (options.forceFullscreen) {
			return viewport;
		}

		if (options.resizeToBestPossibleSize) {
			if (portrait) {
				data = this._calcSize(data, viewport.width, "width", "height");
			} else {
				data = this._calcSize(data, viewport.height, "height", "width");
			}
		}

		if (options.resizeAccordingToViewport || options.resizeToBestPossibleSize) {
			if (viewport.width < data.width) {
				data = this._calcSize(data, viewport.width, "width", "height");
			}
			if (viewport.height < data.height) {
				data = this._calcSize(data, viewport.height, "height", "width");
			}
		}

		return data;
	},

	_calcSize: function( data, value, sortBy, toSort ) {
		var newData = {};

		newData[toSort] = Math.max(0, (data[ toSort ] / data[ sortBy ]) * value);
		newData[sortBy] = value;

		return newData;
	},

	_size: function() {
		// overwrite options with recalculated dimensions
		$.extend(this.options, this._getSize(this.options));

		if (this._isVisible && this.options.useAnimation) {
			this._animateSize();
			return;
		}

		if (this.options.useContentSize) {
			this._contentSize();
			return;
		}

		this._super();
	},

	/*
	 * Sets the size of the dialog
	 *
	 * Options width and height define content size, not overall size
	 */
	_contentSize: function() {
		// If the user has resized the dialog, the .ui-dialog and .ui-dialog-content
		// divs will both have width and height set, so we need to reset them
		var nonContentHeight, nonContentWidth, actualSize,
			options = this.options;

		// Reset content sizing
		nonContentWidth = this.element.show().css({
			width: options.width,
			minHeight: 0,
			maxHeight: "none",
			height: 0
		}).outerWidth() - options.width;
		this.element.css("width", "auto");

		if (options.minWidth > options.width + nonContentWidth) {
			options.width = options.minWidth;
		}

		// reset wrapper sizing
		// determine the height of all the non-content elements
		nonContentHeight = this.uiDialog.css({
				height: "auto",
				width: options.width + nonContentWidth
			})
			.outerHeight();

		actualSize = this._getSize({
			width: options.width + nonContentWidth,
			height: options.height + nonContentHeight
		});

		this.uiDialog.css("width", actualSize.width);
		this.element.height(Math.max(0, actualSize.height - nonContentHeight));

		if (this.uiDialog.is(":data(ui-resizable)") ) {
			this.uiDialog.resizable("option", "minHeight", this._minHeight());
		}

		// save calculated overall size
		$.extend(options, actualSize);
	},

	// Processes the animated positioning (position using callback), works with any width and height options
	_animateUsing: function( position, data ) {
		var that = this;
		// calculate new position based on the viewport
		position.left = ( data.target.left + ( data.target.width - this.options.width - ( this.uiDialog.outerWidth() - this.uiDialog.width() ) ) / 2 );
		position.top = ( data.target.top + ( data.target.height - this.options.height ) / 2 );
		if (position.top < 0) {
			position.top = 0;
		}

		this.uiDialog.animate(position, $.extend({}, this.options.animateOptions, {
			complete: function() {
				that._trigger("resized");
			}
		}));
	},

	// animated the size, uses width and height options like default dialog widget (overall size)
	_animateSize: function() {
		var options = this.options;

		this.uiDialog.animate({
			width: options.width
		}, options.animateOptions);

		this.element.animate({
			// options.height is overall size, we need content size
			height: options.height - ( this.uiDialog.outerHeight() - this.element.height() )
		}, options.animateOptions);
	},

	// position overwrite for animated positioning
	_position: function() {
		var that = this;
		this._positionOptions = this.options.position;
		// change position.using mechanism
		if (this.options.useAnimation && this._isVisible) {
			this.options.position.using = function(position, feedback) {
				that._animateUsing(position, feedback);
			};
		}
		this._super();
		// reset position.using mechanism
		this.options.position = this._positionOptions;
	},

	// ARIA helper
	setAriaLive: function(busy) {
		this.uiDialog.attr({
			"aria-live": "assertive",
			"aria-relevant": "additions removals text",
			"aria-busy": busy
		});
	},

	// all following functions add a variable to determine if the dialog is visible
	_create: function() {
		this._super();
		this._isVisible = false;
		this._oldSize = {
			width: this.options.width,
			height: this.options.height
		};

		// make dialog responsive to viewport changes
		this._on(window, this._windowResizeEvents);

		// add wrapper to dialog
		$('.updraft-dialog').not('.updraft-container > .updraft-dialog').wrap('<div class="updraft-container" />');
	},

	_windowResizeEvents: {
		resize: function(e) {
			if (this.options.resizeOnWindowResize) {
				if (window === e.target) {
					this._addTimeout(function() {
						this._setOptions(this._oldSize);
					});
				} else {
					this._addTimeout(function() {
						this._position();
					});
				}
			}
		},
		scroll: function() {
			// second test prevents initial page load scroll event
			if (this.options.scrollWithViewport && this.timeout) {
				this._addTimeout(function() {
					this._position();
				});
			} else {
				this.timeout = true;
			}
		}
	},

	_addTimeout: function(callback) {
		clearTimeout(this.timeout);
		if (this._isVisible) {
			this.timeout = this._delay(callback, 250);
		}
	},

	_makeResizable: function() {
		this._super();
		this.element.on(this.widgetEventPrefix + "resizestop", this, function(event) {
			event.data.element.css("width", "auto");
			event.data.uiDialog.css("height", "auto");
		});
	},

	_makeDraggable: function() {
		this._super();
		this.element.on(this.widgetEventPrefix + "dragstop", this, function(event) {
			event.data.options.position = event.data._positionOptions;
		});
	},

	open: function() {
		this._super();
		this._isVisible = true;
	},

	close: function() {
		this._super();
		this._isVisible = false;
	},

	focusTabbable: function() {
		this._focusTabbable();
	},

	_createOverlay: function() {
		this._super();
		if (this.options.modal && this.options.closeModalOnClick) {
			this._on(this.overlay, {
				mousedown: function(event) {
					this.close(event);
				}
			});
		}
	}
});

}( jQuery ));
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</style>
<style id='mfn-custom-inline-css' type='text/css'>
/* Header */
#Action_bar a { color: #a7afcd; }

.post-title h2.entry-title { font-size: 22px; line-height: 27px; padding: 0; background: none; }

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table { border-collapse: separate !important; border-spacing: 0 3px; font-size: 105%; }
table thead th { font-size: 16px;  width: 20%; }
table th, table td { border-width: 0; padding: 17px 10px; }
table tr:nth-child(1n) td { background:#f3f5f7; }
table th, table tr:nth-child(2n) td { background:#eff7fb; }


@media only screen and (max-width: 767px) {
.language-box { max-width: 380px; display: block; margin: 0 auto; }
}
</style>
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	<div id="Subheader"><div class="container"><div class="column one"><h4 class="title">Microsurgical Epididymal Sperm Aspiration (MESA)</h4><ul class="breadcrumbs no-link"><li><a href="https://www.mkmcare.com">Home</a> <span class="mfn-breadcrumbs-separator"><i class="icon-right-open"></i></span></li><li><a href="https://www.mkmcare.com/centre-of-excellence/">Centre of Excellence</a> <span class="mfn-breadcrumbs-separator"><i class="icon-right-open"></i></span></li><li><a href="https://www.mkmcare.com/centre-of-excellence/endourology/">Urology</a> <span class="mfn-breadcrumbs-separator"><i class="icon-right-open"></i></span></li><li><a href="https://www.mkmcare.com/centre-of-excellence/endourology/penis-scrotal-infertility/">Penis, Scrotal &#038; Infertility</a> <span class="mfn-breadcrumbs-separator"><i class="icon-right-open"></i></span></li><li><a href="https://www.mkmcare.com/centre-of-excellence/endourology/penis-scrotal-infertility/microsurgical-epididymal-sperm-aspiration-mesa/">Microsurgical Epididymal Sperm Aspiration (MESA)</a></li></ul></div></div></div>
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<h3>Microsurgical Epididymal Sperm Aspiration (MESA)</h3>
<p>Azoospermia, or the condition of no sperm in the ejaculate, happens either because there is a blockage in the reproductive tract or a deficiency in sperm production.</p>
<p>For many men with this type of infertility, a surgical procedure is necessary to extract sperm directly from the epididymis, where mature sperm are stored, or the testicles, where they are produced.</p>
<p>The era of In Vitro Fertilization (IVF) with ICSI has allowed the reproductive laboratory to fertilize an egg with just a single sperm by placing the sperm directly into the egg. This has lowered the requirement for the number of sperm needed to get pregnant from millions to just a few.</p>
<p><img fetchpriority="high" decoding="async" class="alignnone size-full wp-image-10130" src="http://www.worldarthroplastyday.com/wp-content/uploads/2020/10/Microsurgical-Epididymal-Sperm-Aspiration.jpg" alt="" width="1024" height="1573" srcset="https://www.mkmcare.com/wp-content/uploads/2020/10/Microsurgical-Epididymal-Sperm-Aspiration.jpg 1024w, https://www.mkmcare.com/wp-content/uploads/2020/10/Microsurgical-Epididymal-Sperm-Aspiration-195x300.jpg 195w, https://www.mkmcare.com/wp-content/uploads/2020/10/Microsurgical-Epididymal-Sperm-Aspiration-667x1024.jpg 667w, https://www.mkmcare.com/wp-content/uploads/2020/10/Microsurgical-Epididymal-Sperm-Aspiration-768x1180.jpg 768w" sizes="(max-width:767px) 480px, (max-width:1024px) 100vw, 1024px" /></p>
<p>Extracting sperm from their storage site in the epididymis is an excellent way of getting sperm to use for IVF in patients with a blockage in the reproductive tract.</p>
<p>Microsurgical Epididymal Sperm Aspiration or MESA is a relatively painless and minimally invasive procedure performed in our office under local anesthesia.</p>
<p>Only a very small incision need be made under local anesthesia to be able to access the epididymis. Using magnification, Dr. Werthman can see the tiny epididymal tubules and open several to get the sperm contained within. Usually enough sperm can be obtained to freeze for multiple cycles of IVF.</p>
<p>The sperm that are removed are always checked immediately under a microscope. If they are not very good quality, Dr. Werthman will proceed to remove sperm fluid directly from the testicle through the same small incision.</p>
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<li id="menu-item-10586" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10586"><a href="https://www.mkmcare.com/centre-of-excellence/endourology/penis-scrotal-infertility/dorsal-slit-circumcision/">Dorsal Slit Circumcision</a></li>
</ul></div></aside></div></div><div class="column mobile-one tablet-one-fourth one-fourth"><div class="mcb-column-inner"><aside id="nav_menu-15" class="widget widget_nav_menu"><h4>Ureteric Procedures</h4><div class="menu-ureteric-procedures-container"><ul id="menu-ureteric-procedures" class="menu"><li id="menu-item-10567" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10567"><a href="https://www.mkmcare.com/centre-of-excellence/endourology/ureteric-procedures/ureteroscopy-with-holmium-laser-lithotripsy-of-kidney-stone/">Ureteroscopy with Holmium Laser Lithotripsy of Kidney Stone</a></li>
<li id="menu-item-10568" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10568"><a href="https://www.mkmcare.com/centre-of-excellence/endourology/ureteric-procedures/laparoscopic-management-of-all-type-of-ureteric-stricture-laparoscopic-uretero-urostomy-laparoscopic-ureteric-reimplantation-boari-flap/">Laparoscopic Management of all type of Ureteric Stricture (Laparoscopic Uretero-Urostomy, Laparoscopic Ureteric Reimplantation, Boari Flap)</a></li>
</ul></div></aside><aside id="nav_menu-16" class="widget widget_nav_menu"><h4>Urethra</h4><div class="menu-urethra-container"><ul id="menu-urethra" class="menu"><li id="menu-item-10594" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10594"><a href="https://www.mkmcare.com/centre-of-excellence/endourology/urethra/urethral-stones-surgery/">Urethral Stones Surgery</a></li>
<li id="menu-item-10595" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10595"><a href="https://www.mkmcare.com/centre-of-excellence/endourology/urethra/hypospadias-surgery/">Hypospadias Surgery</a></li>
</ul></div></aside><aside id="nav_menu-17" class="widget widget_nav_menu"><h4>Vascular Procedures</h4><div class="menu-vascular-procedures-container"><ul id="menu-vascular-procedures" class="menu"><li id="menu-item-10602" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10602"><a href="https://www.mkmcare.com/centre-of-excellence/vascular-procedures/varicose-veins/">Varicose Veins</a></li>
<li id="menu-item-10603" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10603"><a href="https://www.mkmcare.com/centre-of-excellence/endourology/penis-scrotal-infertility/circumcision/">Circumcision</a></li>
<li id="menu-item-10604" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10604"><a href="https://www.mkmcare.com/centre-of-excellence/vascular-procedures/circumcision-with-staplers/">Circumcision with Staplers</a></li>
<li id="menu-item-10605" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10605"><a href="https://www.mkmcare.com/centre-of-excellence/vascular-procedures/hydrocele/">Hydrocele</a></li>
</ul></div></aside><aside id="nav_menu-18" class="widget widget_nav_menu"><h4>Laparoscopic Procedures</h4><div class="menu-laparoscopic-procedures-container"><ul id="menu-laparoscopic-procedures" class="menu"><li id="menu-item-10591" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10591"><a href="https://www.mkmcare.com/centre-of-excellence/laparoscopic-procedures/lap-cholecystectomy/">Lap Cholecystectomy</a></li>
<li id="menu-item-10592" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10592"><a href="https://www.mkmcare.com/centre-of-excellence/laparoscopic-procedures/inguinal-hernia/">Inguinal Hernia</a></li>
<li id="menu-item-10593" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10593"><a href="https://www.mkmcare.com/centre-of-excellence/laparoscopic-procedures/umbilical-hernia/">Umbilical Hernia</a></li>
</ul></div></aside></div></div><div class="column mobile-one tablet-one-fourth one-fourth"><div class="mcb-column-inner"><aside id="nav_menu-19" class="widget widget_nav_menu"><h4>Proctoscopy</h4><div class="menu-proctoscopy-container"><ul id="menu-proctoscopy" class="menu"><li id="menu-item-10596" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10596"><a href="https://www.mkmcare.com/centre-of-excellence/proctoscopy/hemorrhoidectomy-with-stapler/">Hemorrhoidectomy with Stapler</a></li>
<li id="menu-item-10597" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10597"><a href="https://www.mkmcare.com/centre-of-excellence/proctoscopy/hemorrhoidectomy/">Hemorrhoidectomy</a></li>
<li id="menu-item-10598" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10598"><a href="https://www.mkmcare.com/centre-of-excellence/proctoscopy/fissurectomy/">Fissurectomy</a></li>
<li id="menu-item-10599" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10599"><a href="https://www.mkmcare.com/centre-of-excellence/proctoscopy/fistulectomy/">Fistulectomy</a></li>
<li id="menu-item-10600" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10600"><a href="https://www.mkmcare.com/centre-of-excellence/proctoscopy/abscess-discharge/">Abscess Discharge</a></li>
<li id="menu-item-10601" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-10601"><a href="https://www.mkmcare.com/centre-of-excellence/proctoscopy/pilonidal-sinus/">Pilonidal Sinus</a></li>
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