If the cause of infertility in the man is low sperm count or azoospermia (zero sperm count), or he has undergone vasectomy for contraception, surgical sperm retrieval can be done. This is followed by ICSI (intra-cytoplasmic sperm injection) to bring about fertilization of the egg.

ICSI has been a breakthrough procedure for male fertility problems as even a single viable sperm is enough to bring about fertilization as compared to the thousands normally required. Now, for cases where there is no sperm in the male ejaculate, infertility specialists have found other sources including the vas deferens, epididymis, and testicles, form where they can extract a sperm using one of the below aspiration techniques.

Methods of Sperm Retrieval

·         PESA (Percutaneous Epididymal Sperm Aspiration)

A short, almost painless procedure in which sperm is collected by inserting a fine needle into the epididymis through the scrotum. The procedure only takes about 15-20 minutes.

·         TESA (Testicular Sperm Aspiration)

If the epididymal fluid does not contain sperm, TESA is performed. In this, the needle is inserted into the testes and some tissue is aspirated and checked for presence of sperm. This is also a very short and painless procedure and requires no surgical incision.

·         TESE (Testicular Sperm Extraction) / Testicular Biopsy TESE

If no sperm is aspirated by the above two methods, testicular biopsy is performed. In this procedure a small incision is made in the testis and a small part of the tissue is excised and examined for sperm.

The procedure is done under anesthesia and may cause pain and tenderness for a few days.

For ICSI with surgical sperm retrieval, get in touch via the form on the right.

Surgical sperm retrieval

Effectiveness of SSR

ICSI is performed the same day with the freshly taken sperm sample, and if the doctor determines it good enough, the sample can also be frozen for subsequent use. Fertilization potential of the sperm is usually not affected. IVF is usually not advisable in these cases because the sperm count is low.

If the retrieved sperm is non-motile, fertilization rates may be poor because it cannot be determined if it is dead or alive. The best is to ask your fertility doctor for her suggestion after examining the sperm sample and then proceed with ICSI or opt for IVF with donor sperm.

For more information on ICSI with PESA/TESA, contact us via the form on this page.

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