Surgical Sperm Retrieval

Surgical Sperm Retrieval is a process where we collect the sperms from the epididymus or testes through a fine needle or through a biopsy samples from the testes. This procedure is necessary if there may be because of any blockage in one of the tubes that carry sperm from the areas of the testes where they are produced, out to the penis during ejaculation. Different reasons may be as follows:

 

·         An obstruction preventing sperm release, due to injury or infection

·         Congenital absence of the vas deferens (men born without the tube that drains the sperm from the testicle)

·         Vasectomy

·         Non-obstructive azoospermia - the testicles are producing such low numbers of sperm that they don't reach the vas

In the first three conditions, sperm are produced by the testes, but are unable to be ejaculated because of the blockage or absence of the vas. The man can still ejaculate seminal fluid but this fluid will not contain any sperm. It is possible to collect sperm directly from the epididymis.

Occasionally it may be possible to surgically unblock the tube that carries the sperm during the ejaculation process, although this has a low success rate. In cases of vasectomy surgical correction in the form of vasectomy reversal may offer another treatment to this problem.

 

Surgical sperm retrieval includes different types of methods as follows:

  • PESA: percutaneous epididymal sperm aspiration.
  • MESA: microsurgical epididymal sperm aspiration.
  • TESA: testicular sperm aspiration. This includes testicular fine needle aspiration (TFNA).
  • TESE: testicular sperm extraction.
  • Microdissection TESE.
  • Perc biopsy: percutaneous biopsy of the testis.

Which method is used depends on the nature of the problem in the male partner, which needs to be explored carefully first.