Sperm retrieval is a collective term used for variety of surgical procedures that are performed to obtain sperm other than ejaculation. These surgical procedures are designed to help men who have lower than normal quantity of sperm or absent sperm (azoospermia) in semen leading to infertility. In such cases the sperms are directly extracted from the male organs such as epididymis or testicles.
The different procedures include:
Percutaneous epididymal sperm aspiration (PESA) – is the simplest surgical sperm retrieval procedure, usually performed under local anesthesia. During this procedure the sperm may be extracted with a fine needle from the epididymis
Testicular sperm aspiration (TESA) and Testicular Sperm Extraction (TESE) In some cases where no sperm is present in the epididymis due to various reasons such as:
- Blockage in the epididymis that prevents sperm entry
- Blockage in the testicles
- Very low sperm count that can not reach the ejaculate
In such cases sperm may be extracted directly from the testis, through TESA or TESE procedure.
The numbers of sperm are limited in the testicular tissue; because of that generally this procedure is used in conjunction with IVF and ICSI.
Testicular sperm extraction (TESE)
During this procedure some testicular tissue is removed through biopsy after giving local or general anesthesia to patient, the tissue is then processed and eventually the sperm is extracted.
Additional information about the Testicular sperm aspiration (TESA) procedure
Preparation for the procedure
- Do not eat or drink for 6-8 hours before procedure.
- Arrange for a family member or friend for the help after the procedure
- It is recommended to avoid smoking, alcohol and other recreational drugs few days before the procedure.
- Consult a urologist and have a list of medicines that are to be taken and needs to be stop
During the procedure
- Patient is put under local (or general) anesthesia. The specialist/urologist make a small incision in the scrotum to expose the testicles. A needle in inserted into one testicle at pressure to retrieve the sperm.
- The whole procedure may take about 30 min to an hour and can be carried out at special surgical unit or at hospital.
- Patient can return home on the same day as the anesthesia worn off. Patient may have slight discomfort and mild swelling for a few days post the TESA
- Immature sperm can be retrieved from this procedure and it does not provide enough sperm for cryopreservation to be used in future. No major risks associated with TESA however, the other risk include,
- Bleeding or injury to arteries can cause loss of blood supply to testes
- Risk of infection
- Reaction to anesthesia
The surgical sperm retrieval procedures are useful for male who wants to become a father of own child, where there is no sperm in their ejaculate (azoospermia) due to various reasons or there is inadequate sperm production
No hospitalization is required for PESA, TESE and TESA; patient can expect to return home next day of the procedure. It is recommend consulting with fertility doctor about benefits and risk associated with the procedure before deciding to travel for sperm retrieval procedure.