Surgical sperm retrieval is the process of taking out sperms directly from epididymis or testes of male if they are suffering from:
- azoospermia (absence of sperms)
- very low or poor quality semen
- ejaculatory dysfunction
Though it is an invasive procedure but enables infertile men to have their own genetic child. The sperms obtained through SSR are very less in number and with limited or no motility; hence they can be used only through IVF-ICSI. According to the organ from which sperms are retrieved and the complexity of method, SSR involves four types of procedures: PESA, TESA/ TESE/ MicroTESE.
PESA (Percutaneous Epididymal Sperm Aspiration)
PESA is the simplest SSR and very effective in patients with obstructive azoospermia, post vasectomy or congenital absence of vas deferens. Under local anesthesia a fine needle attached with syringe is inserted into the epididymis and fluid is aspirated. This fluid is checked for presence of sperms which are utilized for ICSI or frozen for later use.
TESA (Testicular Sperm Aspiration)
TESA is minimally invasive procedure done under local anesthesia where a butterfly needle attached to a syringe is inserted in the testes and the testicular tubules are aspirated. The sperms are isolated from tubules in the embryology lab and checked for maturity. The sperms can be used for ICSI or frozen for later use.
TESE (Testicular Sperm Extraction)/Testicular Biopsy
If there are no sperms on TESA or there is focal spermatogenesis, testicular biopsy under short anesthesia is performed. It is a day care procedure where though a small incision on the testes, testicular tissue is extracted and checked for the presence of sperms. Incision is closed with suture and medications are advised.
Microsurgical TESE/ MicroTESE
MicroTESE is an extensive procedure done under general anesthesia for men who have non obstructive azoospermia or failed TESA/TESE. The testes are surgically opened and tubules are inspected under microscope to locate healthy areas that are more likely to contain sperm. The sperms are retrieved and utilized for ICSI.