Some men have no sperm in their semen, a condition called azoospermia. In many of these men, sperm can still be found in the testes or the tubes that carry sperm. Surgical sperm retrieval collects these sperm so they can be used in IVF with ICSI.
Who needs sperm retrieval?
- Obstructive azoospermia: sperm are produced but a blockage stops them reaching the semen, for example after a vasectomy, infection or because the vas deferens is absent from birth
- Non-obstructive azoospermia: sperm production in the testes is very low
- Problems with ejaculation: such as after spinal cord injury
A semen analysis, hormone tests and sometimes genetic tests help decide which method is suitable. See genetic testing.
Methods of sperm retrieval
PESA
Percutaneous epididymal sperm aspiration uses a fine needle to collect sperm from the epididymis, usually for obstructive azoospermia.
TESA
Testicular sperm aspiration uses a fine needle to collect tissue from the testis. See TESA.
Micro-TESE
Microdissection testicular sperm extraction uses an operating microscope to find small areas of sperm production, mainly for non-obstructive azoospermia. See micro-TESE.
Is sperm retrieval painful?
These procedures are done under local anaesthetic or sedation, so most men feel little pain during the procedure. Needle methods such as PESA and TESA are quick, often taking 15 to 30 minutes. Mild soreness and swelling afterwards are common and usually settle within a few days with simple pain relief.
Recovery
- Most men go home the same day
- Wear supportive underwear and rest for a day or two
- Avoid heavy lifting and strenuous exercise for about a week, or as advised
- Contact the clinic if there is significant swelling, fever or increasing pain
What happens to the sperm?
Retrieved sperm are used for ICSI, where a single sperm is injected into each egg. Sperm can be used fresh on the day of egg collection or frozen for later cycles. See surgery for male infertility.
Will sperm always be found?
In obstructive azoospermia, sperm are found in most men. In non-obstructive azoospermia, the chance is lower and depends on the cause. Your doctor will discuss your chances and alternatives, such as donor sperm, beforehand.
Frequently asked questions
Is sperm retrieval done under anaesthesia?
Yes. It is done under local anaesthetic or sedation, so most men feel little pain during the procedure.
How long does recovery take?
Most men recover within a few days. Strenuous activity is usually avoided for about a week.
Can sperm be retrieved after a vasectomy?
Yes. Sperm can usually be retrieved from the epididymis or testis and used for ICSI.
If you have questions about your own situation, you can meet our doctors at our Basavanagudi, Koramangala and Ballari centres, or contact us to book an appointment.
This article is for general information and does not replace medical advice. Treatment decisions should be made with a qualified doctor who knows your history.