Treatments & Services

Surgical sperm retrieval

What is a surgical sperm retrieval?

When sperm is not present in the ejaculate, or there is an inability to ejaculate, surgical sperm retrieval may be recommended in order to collect sperm for treatment. The term “surgical sperm retrieval” collectively describes the surgical techniques that are used to remove sperm from the testicle or epididymis.

How is a surgical sperm retrieval performed?

The procedure is performed either under a local anaesthetic or sedation in our Day Surgery rooms, and can be performed in the following ways:

PESA

Percutaneous Epididymal Sperm Aspiration (PESA) involves a fine needle being passed into the epididymis to extract fluid, which is then immediately checked by the embryologist for the presence of sperm. The epididymis is a duct that sits behind the testis where sperm cells collect and mature prior to ejaculation.

TESA

Testicular Sperm Aspiration (TESA) involves a fine needle being passed into the testis to remove very thin pieces of testicular tissue. The tissue is then checked in the laboratory by the embryologist for the presence of sperm.

TESE

Testicular Sperm Extraction, or Testicular Biopsy (TESE), involves a small incision in the testis and a small sample of testicular tissue being removed. The tissue then checked in the laboratory by the embryologist for the presence of sperm.

Recovery from the procedure can be dependent on how invasive the collection technique is, but men can usually go back to work the day after. If the procedure is performed under sedation (i.e. light anaesthetic), you will need to have a support person to take you home as you will not be able to drive afterwards.

How can I tell if sperm will be successfully collected?

Not all patients are suitable for this technique and occasionally, no viable sperm can be recovered. Sperm can only be obtained if the testis is producing sperm.

Investigations will be performed by your fertility doctor to help predict whether sperm will be obtained, which may include hormone tests, physical examinations and genetic testing.

What happens if sperm are successfully collected?

If a surgical sperm retrieval is being performed alongside an IVF treatment cycle, then the sperm that is successfully collected will be used to try and fertilise any eggs that are also collected on the day. If the surgical samples have enough viable sperm available for freezing to occur, this sample can potentially be thawed and used in a subsequent IVF treatment cycle without having to repeat the procedure of sperm retrieval.

Sometimes a surgical sperm retrieval is performed prior to an IVF treatment cycle. If enough viable sperm are found in this sample, this can be frozen and used in future IVF cycles. The presence or absence of viable sperm can help you decide on future IVF treatment options including the use of donor sperm.