Surgical sperm retrieval

Surgery is another way to collect sperm for treatment.   

The vas deferens is the tube that carries your sperm. If it’s blocked, or missing entirely, then you won’t have any sperm in your semen – but with minor surgery, we might still be able to collect your sperm through surgical sperm retrieval.  

Could surgical sperm retrieval be right for me?

Around 1 in 100 men don’t have any sperm in their semen, which is known as azoospermia. If we’ve found that you don’t have any in yours, or that you’re producing a very low number of sperm, this could be because:

  • The vas deferens is missing
  • The vas deferens is blocked, possibly due to vasectomy
  • You have another testicular disorder.

Even so, if your testicles are still producing sperm we might be able to collect some surgically – but surgical sperm retrieval won’t always be right for every patient. If you’re wondering if you need this treatment, talk to your consultant or contact CARE Fertility; they might recommend multiple ejaculation resuspension and centrifugation (MERC) first.

What does it involve?

Surgical sperm retrieval is usually done under local anaesthetic or sedation with pain relief, and can be carried out in one of three ways.

  • Percutaneous epididymal sperm aspiration (PESA)
    With PESA, we insert a fine needle into the epididymis – a tube at the back of the testicles that stores and carries sperm – and collect sperm using gentle suction.
  • Testicular sperm aspiration (TESA)
    Here we use a small syringe and needle to take sperm directly from the testis.
  • Testicular sperm extraction (TESE)
    During the TESE procedure, we make a slight incision in the skin on the top of the testicle and take a small tissue sample. We then extract any sperm cells we find in the tissue.

If you’re suffering from a simple blockage the chance of recovering sperm by PESA, TESA or TESE is almost 90%, and with abnormalities of the testes there’s an average 50 to 60% chance.

After the surgery, we’ll usually let you know on the same day whether we’ve managed to find any sperm. In more complicated cases of TESE, however, we might need to incubate the tissue for a short time before we can recover any sperm.