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Surgical sperm retrieval, also called surgical sperm recovery, describes different procedures to surgically retrieve sperm directly from the testes. These procedures are generally advised when the male partner has a condition called azoospermia, which is where there is no sperm present in their ejaculate.
So, if you don’t release sperm when you ejaculate, but your testes do produce sperm, a specialist may be able to extract sperm directly from your testicles, which can then be used in further fertility treatments such as IVF or intrauterine insemination.
At Circle Health Group, we offer four main types of surgery to retrieve sperm from the testes:
- Open testicular biopsy with microsurgical techniques
- Percutaneous epididymal sperm aspiration (PESA)
- Testicular epididymal sperm extraction (TESA)
- Micro epididymal sperm aspiration (MESA)
Below you’ll find more detailed information on each of these treatments. Which type of extraction is best for you will depend on personal factors to do with the cause of your fertility problems.
If you would like advice on surgical sperm recovery, which type of retrieval is best for you, or anything else to do with your fertility journey, book an appointment with one of our experienced specialists. You can use our easy online booking portal, or call to speak to one of our advisors.
This procedure is commonly recommended for patients whose semen analysis suggests abnormalities or does not show evidence of sperm. Open testicular biopsy can help diagnose the cause of abnormal sperm as well as extracting sperm that can then be used for further fertility treatments. Once the cause has been identified, appropriate fertility treatments can be recommended.
What happens during an open testicular biopsy?
This is the most invasive of the four listed methods to obtain sperms from men with azoospermia. It is performed under anaesthetic.
Your surgeon will make very small incisions (cuts) into your testicles and take samples of tissue from them. These are extracted to look for sperms. If sperms are found then they can be used for further assisted conception methods to fertilise the egg from the female partner.
These methods are generally safe; there is a risk of infection and bleeding as with any surgery, but it is a low risk. The success of the operation in leading to a pregnancy depends on various other factors, but the procedure certainly increases the chances.
Who can benefit from this procedure?
If your semen analysis has shown abnormalities, you may be recommended this procedure. For further information on this procedure and to discuss your options with a consultant, make an enquiry with us today.
In this procedure sperm is recovered directly from the epididymis (where sperm are stored from each testicle).
What does the procedure involve?
PESA is usually carried out under local anaesthetic by the consultant urologist. A fine needle will be inserted into the epididymis. Sperm can then be removed with gentle suction using a syringe. It is normal to feel some discomfort in the groin for a few days after this procedure, but this will settle with mild painkillers.
Who can benefit from this procedure?
PESA is appropriate for men who have no sperm in the ejaculate because they are born with no vas deferens (the sperm-carrying tube), or because the tube is blocked. PESA is also suitable for men who have had a vasectomy, which stops the flow of semen into the ejaculate.
One of the benefits is that it is a relatively low cost procedure that can be repeated multiple times.
Testicular epididymal sperm extraction involves taking a sample of testicular tissue to see if sperm are present.
The procedure
TESA is usually carried out under local anaesthetic by the consultant urologist. A small cut is made into the testicle and a tiny sample of testicular tissue is removed, before being carefully examined for the presence of sperm.
If excess sperm are recovered, they may be frozen for use in a later treatment cycle. This means that it would not be necessary to recover further sperm until the frozen sperm was used up.
Who can benefit from this procedure?
Like PESA, TESA is appropriate for men who have no sperm in their ejaculate because they are born with no vas deferens (the sperm-carrying tube), because the vas deferens has become blocked, or as a result of a vasectomy.
MESA is usually carried out under general anaesthetic by the consultant urologist. A small cut is made in the scrotum to expose the epididymis (where sperm are stored from each testicle), and through this your consultant can remove the sperm.
It is normal to feel some discomfort in the groin for a few days after this procedure, but this will settle with mild painkillers.
Who can benefit from this procedure?
Again, MESA is appropriate for men who have no sperm in the ejaculate because they are born with no vas deferens (the sperm-carrying tube), or because it is blocked. MESA is also suitable for men who have had a vasectomy.
At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:
- Flexible appointment times and locations that are convenient for you
- The freedom to choose which hospital and consultant suit your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms should you need to stay overnight
- A range of delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to see a consultant or learn more about any of our fertility treatments, book your appointment online today or call a member of our team directly.
Content reviewed by Circle in-house team in March 2023. Next review due March 2026.
- Microsurgical retrieval of epididymal sperm, malefertility.org
- Surgical sperm retrieval for male infertility, NHS
- Azoospermia, NIH
