Surgical Sperm Retrieval
Surgical sperm retrieval is a technique designed to bypass the need for sperm to be released via ejaculation. Discover how these methods can help to overcome male fertility problems.
When is surgical sperm retrieval needed?
Surgical sperm retrieval techniques are typically used in cases of azoospermia, when there is no sperm present in the ejaculate. There can be many causes of azoospermia, including having a defect of the vas deferens, hormone disorders, infections, or chromosomal abnormalities. Sperm obtained from these procedures can then be analysed and used for assisted reproductive technologies, such as ICSI, to improve your chances of having a baby.
Ying may also suggest surgical sperm retrieval for couples wishing to conceive but who are affected by challenges with ejaculation or sperm DNA fragmentation. Patients undergoing oncofertility treatment prior to cancer therapy may also be offered surgical sperm retrieval as a method of collecting sperm for freezing and storage. Each case is unique and Ying will undertake comprehensive fertility testing to understand your situation before recommending surgical sperm retrieval.
Types of surgical sperm retrieval
There are several different approaches to surgical sperm retrieval, some of which are better suited for specific situations. All these procedures are performed under general anaesthesia in Genea’s fully-equipped facilities, where tissue and fluid obtained during the operation can be transferred immediately to the care of embryologists for analysis.
TESA/TESE
Testicular sperm aspiration (TESA)/testicular sperm extraction (TESE) involves inserting a fine needle into the testicles and drawing out small samples of sperm-containing tissue. TESA is typically considered for men with azoospermia due to an obstruction of the vas deferens, such as from having had a vasectomy or damage from trauma.
PESA
Percutaneous epididymal sperm aspiration (PESA) is similar to the TESA procedure but draws tissue from the epididymis rather than the testicles. The epididymis is the tube connecting each testicle to the vas deferens, and also the site for sperm maturation and storage.
Open TESE
Open testicular sperm extraction (TESE) requires small (less than 1cm) incisions in the testicle in order to biopsy a small tissue sample for laboratory analysis. TESE is primarily used for azoospermia caused by issues with sperm production rather than a blockage, but can also be considered if PESA or TESA have been unsuccessful for extracting sperm in men with obstruction-related azoospermia.
MESA
Microepididymal sperm aspiration (MESA) is a more targeted approach to sperm aspiration. An operating microscope is used to locate where sperm is most likely to be found within the epididymis. Directing the aspiration needle to these locations typically results in a larger quantity of good quality sperm.
microTESE
Microdissection testicular sperm extraction (microTESE) is similar to MESA in that it uses a high-definition operating microscope to identify which tubules of the testicles are likely to contain sperm. Tissue from these specific tubules are biopsied to analyse for the presence of sperm. MicroTESE is typically considered the best procedure for men with azoospermia from non-obstructive causes.
Common questions about surgical sperm retrieval
What data is available on surgical sperm retrieval success rates?
The success rate of extracting sperm via these surgical techniques is generally quite high for men with azoospermia from an obstruction (such as a congenital absence of the vas deferens from a genetic disorder or a previous vasectomy). However, these rates are lower for cases of non-obstructive azoospermia (for example, from poor sperm production). Individual success rates for surgical sperm retrieval will vary depending on the exact cause of your azoospermia and the technique used. There is also some research indicating that your age and hormone levels may influence the success of sperm retrieval.
What are the risks of surgical sperm retrieval?
Do I have options if no sperm is found?
If no sperm can be extracted for ICSI, Ying will discuss your next steps, which may involve using donor sperm. This can be a confronting realisation and challenging to accept, but doesn’t mean it’s the end of your hopes of growing your family. Unsuccessful sperm retrieval is highly unlikely in men with obstructive causes of azoospermia, but can be a reality for those with non-obstructive causes.
Consider your options for surgical sperm retrieval with Dr Ying Li
With an advanced certification in reproductive endocrinology and infertility, Ying is an accomplished fertility specialist in Sydney who takes a personalised and compassionate approach in helping his patients build their families. Combining his expertise with your personal goals and preferences, he will discuss his recommendations for surgical sperm retrieval and ICSI, ensuring you feel informed and in control throughout your fertility journey.
Consulting Rooms
Level 3, 321 Kent St
Sydney NSW 2000
137 St Johns Rd,
Glebe, NSW 2037
50-52 Gloucester Rd,
Hurstville NSW 2220
Phone and Fax
T: 1300 323 297
F: 02 8212 8944