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What Are Surgical Sperm Retrieval Techniques?
Surgical sperm retrieval techniques are procedures used to collect sperm directly from the epididymis or testicles when sperm is not present in the ejaculate. The most common techniques include TESA, PESA, TESE and Micro-TESE. The recommended method depends on the underlying cause and its effect on sperm production. The resulting sperm can be used for assisted reproductive technologies such as ICSI. Your fertility specialist can help you determine the best approach based on your individual needs.
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Sperm Retrieval Techniques
1. PESA
PESA (Percutaneous Epididymal Sperm Aspiration) involves using a fine needle to collect seminal fluid directly from the epididymis. This procedure is considered when sperm production is normal, but a blockage prevents sperm from entering the semen during ejaculation. PESA is a minimally invasive procedure that retrieves sperm for use in ICSI.
2. TESA
TESA (Testicular Sperm Aspiration) involves using a fine needle to collect seminal tissue or fluid directly from the testicles. This procedure may be considered when sperm needs to be retrieved directly from the testicles. The number of sperm retrieved can vary between individuals.
3. TESE
TESE (Testicular Sperm Extraction) involves removing a small sample of testicular tissue. The sample is then examined in a laboratory to identify sperm. TESE may be recommended if needle aspiration is not appropriate or if a larger tissue sample would increase the chance of finding sperm.
4. Micro-TESE
Micro-TESE (Microsurgical Testicular Sperm Extraction) is performed using an operating microscope. This allows the surgeon to identify the areas of testicular tissue that are most likely to contain sperm-producing tubules. It can be particularly useful in certain cases of non-obstructive azoospermia where sperm production is greatly reduced or occurs only in small areas.
How Does Surgical Sperm Retrieval Work?
The exact process depends on the technique, but the treatment generally follows these steps:
Step 1: Find the Cause
The fertility specialist or urologist reviews the medical history and may recommend semen analysis, physical examination, hormonal tests or genetic testing.
Step 2: Assess Sperm Production
The doctor determines whether sperm production is present and whether an obstruction may be responsible for the absence of sperm in the semen.
Step 3: Choose an Appropriate Retrieval Technique
Based on the results of the examination, the specialist chooses PESA, TESA, TESE, Micro-TESE or other appropriate procedures.
Step 4: Retrieve the Sperm
The procedure is performed using appropriate anaesthesia or pain relief.
Step 5: Examine the Sample
An embryology team examines the retrieved material to identify viable sperm.
Step 6: Use the Sperm for Treatment
If suitable sperm are found, they may be used for ICSI or frozen for future fertility treatment.
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