Fertility Care in Kuching

Recently, I was referred a case by Dr Chieng Hock Tiew, local fertility expert to do open harvesting of sperm from the epididymis and testes. In fact, I have known Dr Chieng Hock Tiew since school days. Subsequently, we collaborated and we were full time (literally full time working through midnight!) teaching at the local university in Kuching.  Dr Chieng has a preference of asking the urologist to look after the men.  Although most fertility centres can harvest their sperm by percutaneous techniques, open technique allows one to examine the epididymis and  to harvest plenty of material.  The epididymal tubules can be seen and the distended ones are aspirated with a needle. The material can often be looked at immediately to see whether they are any good motile sperm. Testicular material can also be harvested.  We have an anaesthetist in attendance to give sedation for patient comfort and safety. The procedure is done under local anaesthetic infiltration.  In my earlier days (20 years ago), I had often been asked to do epididymo-vasostomy.  Initially, I did this under magnification 4 times and subsequently with the help of a microsurgeon, as most urologists do not handle the microscope often enough. I append herein an information leaflet from Dr Chieng Hock Tiew’s clinic which I picked up on the way out.