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Surgical Sperm Retrieval

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Sperm Retrieval

Surgical Sperm Retrieval is a set of procedures designed to help men who have very little or no sperm in their semen (a condition known as azoospermia). Through minor surgical techniques, sperm can be collected directly from the epididymis or testes.

Once retrieved, the sperm are used in In Vitro Fertilisation (IVF) or Intracytoplasmic Sperm Injection (ICSI) to achieve pregnancy. This option offers hope for couples facing severe male factor infertility.

Severe Male Infertility

The male partner has very low or no sperm count in the ejaculate

There is a blockage in the sperm ducts preventing sperm release

The sperm are unable to travel from the testes to the semen naturally

Prior IVF or ICSI attempts showed no viable sperm in the semen sample

Microsurgical Epididymal Sperm Aspiration

MESA

A minor surgical procedure where the surgeon makes a small incision in the scrotum to access the epididymis (the duct that carries sperm from the testes).

Sperm is aspirated (collected) using fine microsurgical techniques.

Performed under local anaesthesia and takes about 30 minutes.

Often used when there is a blockage preventing sperm from entering the ejaculate.

Percutaneous Epididymal Sperm Aspiration

PESA

Similar to MESA, but instead of microsurgery, a fine needle is inserted through the scrotum directly into the epididymis.

Sperm is aspirated into a syringe without requiring an incision.

A simpler procedure than MESA, but yields smaller amounts of sperm.

Suitable for men with obstructive azoospermia.

Testicular Sperm Extraction

TESE

Performed when MESA or PESA do not yield enough sperm.

A small piece of testicular tissue is surgically removed to retrieve sperm directly from the testes.

The tissue is then examined in the laboratory to isolate viable sperm cells.

Useful in cases of non-obstructive azoospermia where sperm production is very limited.

Microsurgical Testicular Sperm Extraction

Micro TESE

A more advanced version of TESE performed under an operating microscope.

The surgeon makes a small incision in the testes and uses high magnification to identify areas most likely to contain sperm.

Tiny samples of testicular tissue are removed with precision to minimise damage.

The tissue is examined in the laboratory to locate and retrieve viable sperm cells.

Suitable for men with non-obstructive azoospermia or very low sperm production.

Offers higher sperm retrieval rates and reduced tissue removal compared to conventional TESE.

What to Expect

These procedures are day surgeries, usually requiring only local anaesthesia or light sedation.

Recovery is generally quick, with minor discomfort or swelling that subsides within a few days.

Recovery is generally quick, with minor discomfort or swelling that subsides within a few days.

Success Rates

The success of surgical sperm retrieval depends on the underlying cause of infertility.

When combined with ICSI, even a single healthy sperm can result in a successful pregnancy.

At advanced fertility centres, surgical retrieval techniques have high rates of viable sperm recovery.

Risks & Considerations

Mild discomfort, swelling, or bruising in the scrotal area

Small risk of infection or bleeding

In rare cases, not enough viable sperm may be retrieved