Sperm retrieval locates and removes the sperm from the male testicles. The procedure is done in several cases including if a patient has an obstruction or blockage in his tubules and non obstructive azoospermia. In addition, men who have had a vasectomy and do not want to undergo a vasectomy reversal may choose to have a sperm retrieval operation. The procedure is used to enable couples to have children or to freeze sperm. The sperm can then be used through artificial insemination allowing the sperm donor’s partner to become pregnant.
Sperm can be retrieved directly from the epididymis, or sperm reservoir, during a retrieval. This is called a PESA or MESA. Alternatively, if the problem is non-obstructive, then sperm will have to be retrieved directly from the testicle using the microdissection testicular sperm extraction technique.
Prior to the procedure, patients will undergo an examination with their doctor to see if they are a candidate for the procedure.
Doctors will go over the patient’s medical history ahead of the operation. In addition, doctors must determine if there is active sperm that can be retrieved.
Recovery depends on the method that was used to retrieve sperm. Recovery can range from a few days to a week. Men should avoid physical activity and work following the procedure. The use of an icepack can alleviate pain and swelling in the penis and scrotum. Patients can be prescribed medication to combat the pain and swelling by their doctors. Patients may also be given antibiotics to prevent infections.
There are essentially 4 sperm retrieval procedures a patient can undergo. A Percutaneous sperm aspiration, or PESA, can be performed when there is a blockage or when patients do not want to undergo a vasectomy reversal. This procedure can typically be completed using a local anaesthetic. Micro epididymal sperm aspiration, or MESA, can be done in the case of a PESA failing previously. MESA is performed under a microscope by surgeons. A small incision is made and sperm is extracted from fine tubules that contain sperm.
A testicular sperm aspiration, or TESA, can also be performed. This can be used for men with blockages or those who suffer from non-obstructive azoospermia. The sperm is retrieved during this method when a needle is inserted into the testis and extracted. However, the success rates of this technique are much lower than that of an open procedure such as the microdissection technique.
The microdissection testicular sperm extraction or mTESE for short, involves taking biopsies or samples directly from the testicle and searching for sperm under an operative microscope. Sperm can also be directly retrieved from the testicle even in patients who may have extremely low quantities of sperm suitable for ICSI in their semen or in those who have high sperm DNA fragmentation. In some studies, it has been shown that retrieving sperm directly from the testicles may improve the success rates of ICSI in these two groups of patients.