What is surgical sperm retrieval?

There are rare cases of male infertility in which normal sperm production or sperm ejaculation is prevented by an obstruction in the complicated tubal system of the testes. In these cases, provided that motile sperm are being produced, it is possible to retrieve sperm through surgical sperm retrieval which uses a very fine needle to extract sperm directly from the epididymis or the testes. Alternatively, if no live sperms are found, a sample of tissue (testicular biopsy) can be taken from the testes and examined under a microscope for sperm cells.

Provided that one or two sperm cells can be surgically retrieved by any of these methods, fertilisation is possible using the microinjection technique of ICSI. If enough sperm is obtained, some sperm may be frozen for later use so that additional extraction procedures may be avoided. All sperm extraction procedures are performed by a urologist, usually under local anaesthetic.

These techniques have proved a revolution in the treatment of men with very severe infertility (with no evidence of sperm in their ejaculate). Until their introduction, men with these disorders simply had no chance of fathering their own biological children; now surgical sperm retrieval of just a few sperm cells from the testes and the technique of ICSI makes fatherhood possible for the most challenging of cases.

Medfem Fertility Clinic provides the following sperm retrieval services:

  • Testicular sperm extraction (TESE) is available for men with obstructions or ejaculatory problems that cannot be treated by any other method. Small samples of testicular tissue are obtained by needle biopsy and a few sperm are painstakingly dissected out of the tissue for use in the ICSI procedure. 
  • Microepididymal sperm aspiration (MESA) and percutaneous epididymal sperm aspiration (PESA) are available for men with obstructed or absent ejaculatory ducts (for example, from unsuccessful vasectomy reversal or congenital absence of the vas deferens). Sperm are aspirated directly from the epididymis (the tiny collecting tubules next to the testes) for use in the ICSI procedure. The few drops of fluid may contain sufficient sperm to be frozen for several ICSI procedures.
  • Vibrostimulation for men with spinal cord injuries, retrograde ejaculation, or failure or absence of ejaculation.

We also perform screening tests and other diagnostic tests for male infertility dependent on cause:

  • Genetic testing (chromosomal)
  • Microdeletion
  • Nuclear chromation fragmentation
  • Hormonal screens
  • Cystic Fibrosis screening

Some of these procedures are performed by a urologist with special training in fertility. 

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