Surgical sperm retrieval is a part of men's infertility treatment process. In certain cases of male infertility (such as azoospermia), a blockage in the complex tubal system of the testes prevents normal sperm production or sperm ejaculation. In these circumstances, sperm can be recovered using surgical sperm retrieval, which employs a very thin needle to harvest sperm straight from the testicles or the epididymis, assuming that motile sperm are being generated. If no live sperms are discovered, another option is to extract a sample of tissue (testicular biopsy) from the testes and look for sperm cells under a microscope.
The microinjection technique of ICSI allows for fertilization if one or two sperm cells can be surgically removed. If enough sperm is retrieved, part of it may be stored for future use in order to prevent the need for repeated extraction operations.
Surgical Sperm Retrieval: Who is it for?
Surgical sperm retrieval is often recommended to men who have little to no sperm in their semen or are unable to ejaculate. Sperm is drawn from the reproductive tracts since it is for males. For IVF (in-vitro fertilization) and ICSI (intracytoplasmic sperm injection), sperm retrieval is advised for a successful pregnancy.
There are several kinds of methods, and they all include genital tract surgery. The most common scenarios where sperm retrieval surgery is recommended to a patient are:
Different Techniques of Surgical Sperm Retrieval
Retrieving sperm surgically can be done in a few different ways. Some common methods or techniques of surgically retrieving sperm are:
Microsurgical Epididymal Sperm Aspiration (MESA)
MESA (Microsurgical Epididymal Sperm Aspiration) is a procedure that can be used on its own or in conjunction with blockage repair surgery. MESA IVF is performed in men who face vassal or epididymal obstruction.
During the procedure, the testicle is made visible by a scrotal skin incision. An operating microscope enables the surgeon to magnify views of the epididymis, which is the tube through which sperm pass after exiting the testis. Sperm that migrate are searched for in the fluid from the epididymis. The fluid is removed for immediate use or stored for later use if moving (motile) sperm are observed.
Percutaneous Epididymal Sperm Aspiration (PESA)
Percutaneous Epididymal Sperm Aspiration or PESA is a painless procedure best for people looking for non-surgical methods. During the procedure, the fluid is sucked from the epididymis after a little needle has been put there. The fluid is next examined for sperm content and motility. A syringe is introduced to delicately extract the fluid during PESA IVF, which is performed under a local anesthetic.
As PESA can be carried out while receiving local anesthesia, it is occasionally preferred over MESA. However, this method is less reliable and collects fewer sperm. Sometimes there aren't enough sperm to preserve for subsequent usage with PESA.
Testicular Sperm Extraction (TESE)
Testicular sperm extraction is the term for sperm extraction performed during open surgical biopsies (TESE). It is done with a biopsy "gun" rather than a needle.
When there are no sperm in the epididymis or if you have a sperm production issue, sperm can be extracted directly from the testicle (nonobstructive azoospermia). The skin is punctured with a needle (aspiration) or cut open to collect a tissue sample (biopsy). However, if your azoospermia is not brought on by blockage, these methods are often inappropriate.
Microdissection TESE (Micro TESE)
Men who are azoospermic and struggle with sperm production can undergo the micro TESE treatment. Micro TESE is carried out in the operating room beneath the operating microscope under general anesthesia. This process is carried out a day before egg retrieval in close coordination with the female partner. This enables both partners to attend to the procedures of the other. During this process, patients cryopreserve sperm for future IVF/ICSI.
Surgical Sperm Retrieval Processes
Surgical sperm retrieval involves many different processes and techniques. These treatment processes is carefully carried out based on the patient’s needs which depends on:
How to Prepare for Surgical Sperm Retrieval
All the patients are briefed by a fertility expert on how to prepare for surgical sperm retrieval. The surgeon's requirements should be followed before being admitted to the hospital. Prior to the treatments, you could also be advised to fast for at least 6 to 8 hours. While it is completely forbidden to drink alcohol for at least 24 hours. Even after surgery, one should refrain from using drugs, engaging in intense activity, drinking alcohol, and engaging in sexual activity for a week after the procedure.
What Tests are Required before Surgical Sperm Retrieval treatment?
Before the procedure is carried out some patients are required to undergo a few tests in order to check the hormones and conduct different analyses. Some of the tests a patient might need are:
Hormone tests:
Measurements are made of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).
Extremely high levels of LH, FSH, and testosterone indicate testicles are not working properly, which greatly reduces the likelihood of producing sperm.
This examination reveals the vas deferens and the lack of congenital conditions.
Chromosome Test:
Chromosome abnormalities may inhibit the generation of sperm. Prior to the biopsy, it is crucial to verify the men's chromosomes.
Cystic Fibrosis Test:
Men without vas deferens are at risk for developing this condition. There is a possibility that a kid will be impacted if it is found in a spouse. If the gene is negative, therapy can continue; if the gene is positive, doctors will offer counseling and support services.
HIV and Hepatitis:
People who save sperm are tested for HIV as well as Hepatitis B and C. This avoids the problems of embryo vessel cross-contamination.
Nepal IVF provides all infertility treatment services including surgical sperm retrieval all under one roof at cost-effective prices. Visit or contact Nepal IVF today for a free consultation and quality service.
