Surgical Sperm Retrieval

Surgical Sperm Retrieval is a method by which sperm is collected directly from the testis or epididymis of a man. The procedure is usually planned ahead and is done while the patient is under a general or local anesthesia, but it can also be done immediately, if necessary, in the case of an emergency. This is usually in a situation where the man is not able to produce semen on the day his partner’s egg is to be collected.

Techniques of Surgical Sperm Retrieval

There are different techniques by which sperm can be retrieved surgically. The technique used depends on whether the testicles do not produce enough sperm during normal ejaculation or the sperm are not able to reach the seminal fluid because of a blockage in the tube that carries the sperm from the testis.

 1. Percutaneous Epididymal Sperm Aspiration (PESA)

PESA is a very quick SSR procedure and relatively painless. It is the least invasive technique and does not require surgical incision. The process is carried out by inserting a needle into the epididymis from which fluid is removed. The fluid removed is examined by embryologists for sperm content and motility. If no viable sperm is found, then another method will be used.

2. Testicular Sperm Aspiration (TESA)

In TESA, a fine needle together with a biopsy gun is used to remove small lengths of the seminiferous tubule that produce sperm. These tubules are then dissected carefully and examined under a microscope to detect sperm which can be used for ICSI or frozen for later use.

3. Micro-epididymal Sperm Aspiration (MESA) 

A small cut is made which passes through the scrotum and into the epididymis instead of using a needle as in PESA. The fluid removed is then examined under the microscope for viable sperm following the same technique.

4. Testicular Sperm Extraction (TESE) / Micro TESE

This method is used only if no sperm is found when the others are used. In TESE, the tissue is gotten after an incision has been made to open the scrotum. The tissue is cut and taken to the IVF lab where it would be prepared.

Micro TESE, is performed under general anesthesia by a surgeon (usually a urologist) using an operating microscope. A scientist takes samples and seeks live sperm in the samples removed from the testis. This is highly skilled work.