Surgical sperm retrieval

When there are no sperm in the ejaculate, sperm can sometimes still be recovered from the testicles by an operation. There are a variety of techniques:

  • PESA (Percutaneous Epididymal Sperm Aspiration- A fine needle is inserted into the epididymis (the sperm reservoir) at the upper area of the testicle and any sperm will be drawn through the needle into a syringe
  • TESA/TESE (Testicular Sperm Aspiration/ Extraction)- A fine needle is inserted into the testicle and tubules and sperm are drawn through the needle into a syringe.
  • Open Testicular Biopsy– if few or no sperm are obtained from the above procedures a biopsy (tissue sample) is taken from the testicle through a small incision. After the procedure 2-3 stitches are placed in the skin, these will dissolve after about 10 days.

These procedures are carried out either under local or general anaesthetic. The sperm can be used either for diagnosis, immediate treatment, or frozen for use in the future treatments. Sperm obtained from this procedure normally need to be used for ICSI treatment.