Surgical sperm retrieval

Techniques for Sperm Recovery

Percutaneous Epididymal Sperm Aspiration (PESA)

A PESA, is generally used where there is a blockage which prevents movement of the sperm between the testis (where sperm is produced) and the penis.

It is usually performed under local anaesthetic and sperm is aspirated directly from the epididymis, (tube containing the sperm), with a very fine needle which has been inserted through the scrotal skin. The embryologist checks the sample for the presence of sperm, under a microscope. Patients are generally informed on the same day whether sperm has been found or not.

Recovered sperm will be frozen for later use. There are generally enough sperm to perform several IVF / ICSI cycles.

Testicular Sperm Extraction (TESE)

TESE is used in cases of non-obstructive azoospermia, or if PESA has been unsuccessful.

It involves the collection of sperm directly from the testis, and so requires a mild degree of sedation with intravenous drugs. Several samples of testicular tissue are collected from different locations within the testis.

A sample from the testicular biopsy is sent for Histological examination in order to obtain a tissue diagnosis and also to rule out the risk of Testicular Cancer, which is known to occur slightly more frequently (1%) in men with non-obstructive azoospermia.

Patients are generally informed within two days of whether sperm has been recovered.

Recovered sperm will be frozen for later use. There are generally enough sperm to perform several IVF / ICSI cycles.

Microepididymal Sperm Aspiration (MESA)

During MESA the scrotum is opened and using a microscope sperm is aspirated from the epididymis. This procedures requires a general anaesthetic to be performed. It is usually performed to retrieve sperm following a vastectomy.

Patients are generally informed on the same day whether sperm has been found or not.

Recovered sperm will be frozen for later use. There are generally enough sperm to perform several IVF / ICSI cycles

Surgical sperm retrieval may be a treatment option for men with:

  • 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 deferens