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Surgical Sperm Retrieval

Infertility in some men may be due to an interruption in the sperm transport passages as a result of either a previous male sterlisation operation (vasectomy), an anatomical birth abnormality (absence of the vas deferens), or a spinal / pelvic injury or operation.

In these cases sperm may need to be surgically collected from the vas deferens, epididymis or testis using one of several surgical sperm retrieval techniques (PESA, MESA or TSA) depending on the cause of the lack of sperm in the semen. These are minor procedures but do require a general anaesthetic and are carried out on a day case basis. After collection the sperm sample is used for ICSI treatment. The sperm may be frozen so that it is available for several treatment cycles.

Percutaneous Epididymal Sperm Aspiration (PESA)

This procedure is short and relatively painless. A fine needle is inserted through the scrotum into the epididymis and fluid is obtained by gentle suction. This fluid is then analysed for sperm content and quality in the laboratory.

Micro-Epididymal Sperm Aspiration (MESA)

This procedure involves using a microsurgical tool to make a small cut through the scrotum and into the epididymis (instead of using a needle as with PESA). The fluid is obtained and analysed for sperm content and quality in the laboratory.

Testicular Sperm Aspiration (TSA / TESE)

If no sperm are found in the epididymal fluid, a fine needle is inserted into the testis. The needle is used to remove a sample of tissue which is then examined for sperm in the laboratory.

Sperm retrieval is often performed in advance of ICSI treatment and frozen.