Sperm Retrieval Procedures

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Surgical sperm retrieval is used when usable sperm is not available in the ejaculate or when ejaculation is not possible. Sperm may be collected from the epididymis or testis and used with ICSI. The appropriate technique depends on whether sperm production is present and whether a blockage is preventing sperm release.

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Common Retrieval Techniques

- PESA - percutaneous epididymal sperm aspiration
- MESA - microsurgical epididymal sperm aspiration
- TESA - testicular sperm aspiration
- TESE - testicular sperm extraction
- Micro-TESE - microscope-assisted testicular sperm extraction for selected non-obstructive azoospermia

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When May Retrieval Be Considered?

- Obstructive azoospermia
- Congenital absence of the vas deferens
- Previous vasectomy
- Failed vasectomy reversal
- Non-obstructive azoospermia after specialist evaluation
- Ejaculatory dysfunction when other methods are unsuccessful
- A need to obtain sperm directly for ICSI

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Before the Procedure

- Repeat semen analysis where appropriate
- Hormonal evaluation
- Physical examination and ultrasound when indicated
- Genetic testing in selected severe sperm-production disorders
- Counselling about the possibility that sperm may not be found
- Coordination with the IVF laboratory and egg-retrieval schedule

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Possible Risks
- Pain, swelling or bruising
- Bleeding or infection
- Testicular tissue injury
- Temporary or persistent change in testosterone in some cases
- Failure to retrieve usable sperm