Sperm Retrieval Procedures

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Sperm Retrieval Procedures

When conception is the goal, most couples willingly agree to a full range of procedures that result in the birth of a child. But that doesn’t mean those procedures can’t be made as comfortable and effective as possible. For men who have no sperm present in the ejaculate, several types of minimally invasive surgical procedures are available to extract sperm from the testicles.

When is Sperm Retrieval Recommended?

Advances in reproductive medicine have allowed men who were previously considered sterile to father biological children. Among these advances is surgical sperm retrieval. The procedure may help men who are unable to produce adequate sperm for a variety of reasons, including:

  • Vasectomy
  • Failed vasectomy reversal
  • Azoospermia (a complete lack of sperm in the semen)
  • Obstructive azoospermia (lack of sperm in the semen due to a blockage in the seminal tract)
  • Absence of the ducts (vas deferens) that carry sperm from the testicles to the urethra
Sperm Retrieval Procedures

MediFlam. Image source: Tesa-Pesa-Mesa Treatment. Accessed via https://www.mediflam.com/medical-tourism/treatments-in-india/tesa-pesa-mesa-treatment

Testicular Sperm Aspiration

Timing of Sperm Retrieval

Performing the harvesting in advance and freezing the sperm until the eggs are harvested allows the couple to make an informed decision about whether to go forward with IVF.

Moreover, it is difficult for many couples to undergo operative procedures the same day because it requires their enlisting other resources to help them get to and from the hospital and to provide assistance at home. IVF laboratories frequently prefer to work with fresh rather than frozen sperm.

As a result, sperm retrieval procedures are typically performed on the day of egg retrieval.

At Footsteps To Fertility Centre, we use different techniques to extract sperm. They include testicular sperm aspiration (TESA), percutaneous sperm aspiration (PESA) and testicular sperm extraction (TESE).

1.Testicular Sperm Aspiration

Testicular Sperm Aspiration (TESA) is a procedure in which a sample of sperm cells is taken directly from the testicular tissue of a man’s reproductive system. The sperm is separated from the tissue and looked at under a microscope in the laboratory. The sperms can then be used right away or frozen for future infertility treatment in conjunction with Intracytoplasmic sperm injection (ICSI) to form an embryo.

There are two types of TESA depending on the indications for the procedure.

i. Obstructive Azoospermia – Percutaneous testicular sperm retrieval:
Obstructive Azoospermia

Types of Azoospermia. Image source: Intracytoplasmic sperm injection: What is ICSI and how much is it? Accessed via https://www.invitra.com/en/intracytoplasmic-sperm-injection-icsi/

Performed under general anesthesia, percutaneous testicular sperm retrieval uses a biopsy needle to extract a small amount of testicular tissue. The tissue is scanned by an embryologist to locate sperm which can then be used in ICSI to fertilize a partner’s egg.

ii. Nonobstructive Azoospermia – Microscopic testicular sperm retrieval:
Nonobstructive Azoospermia

Types of Azoospermia. Image source: Intracytoplasmic sperm injection: What is ICSI and how much is it? Accessed via https://www.invitra.com/en/intracytoplasmic-sperm-injection-icsi/

In conditions such as testicular atrophy, or even post-chemotherapy/radiation, the testes do not produce adequate amounts of sperm. Using a microscope, a search is performed for testicular tubules that appear more developed and contain mature sperm. This procedure offers the most severe cases of male infertility the best chance of identifying sperm and proceeding with ICSI.

What are the Goals of TESA?

The goals of the testicular sperm aspiration procedure are to obtain the best quality sperm, get enough sperm to fertilize an egg from a woman, and to minimize damage to the reproductive organs.

Possible risks of the testicular sperm aspiration procedure include bleeding, infection, and pain or discomfort after the procedure. There is a very rare chance that the testicle itself will be damaged during the procedure.

What are the indications for TESA?

There are many reasons why a TESA may need to be performed, but all involve an inability to produce an ejaculate with sperm sufficient for fertilization.

Testicular sperm aspiration may be useful for men who have fertility problems caused by a blockage that keeps sperm from being ejaculated. This could be caused by previous vasectomy, certain genetic conditions, ejaculation problems, infection, or other conditions.

TESA may be recommended for men who have had a vasectomy but now wish to father a child. TESA allows the man to maintain his vasectomy for future contraception.

Testicular sperm aspiration

2. Testicular Sperm Extraction(TESE)

Testicular Sperm Extraction

TESE involves making a small incision in the testis and examining the tubules for the presence of sperm. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. TESE is usually performed in the operating room with sedation. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI.

MicroTESE, is a procedure in which our sperm retrieval doctors use a microscope to closely examine the tubules from which sperm is extracted; the goal is to extract sperm from the healthiest tubules, which improves the chances of extracting viable specimens.

3. Percutaneous epididymal sperm aspiration (PESA)

Percutaneous epididymal sperm aspiration

Percutaneous epididymal sperm aspiration (PESA) is a procedure in which a needle is inserted through the scrotum into the epididymis (the duct that carries sperm from the testes to the vas deferens) to collect sperm.

It is performed for men who are having sperm retrieved for IVF/ICSI who have obstructive azoospermia from either a prior vasectomy or infection.

Sperm Retrieval Procedures

The sperm retrieval specialist provides couples with the best chances of a successful pregnancy.

We offer complete care for the infertile couple from artificial insemination semen analysis, laparoscopic surgery, in-vitro fertilization, egg donor, and a shoulder to cry on if you need it.

Our goal is to help you achieve your goal, using the most up-to-date technology.

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