Surgical Retrieval of Sperm

Retrieving sperm surgically may be necessary in many cases. The sperm may be retrieved in order to be frozen or used immediately. Sperm freezing is needed during IVF or when pregnancy is desired but not at the current time. When collecting semen naturally (during orgasm) is not possible, surgical retrieval is necessary. Another case is for infertile men who have no sperm in their ejaculate. 40% of such cases are due to obstruction in the reproductive tract. Problems with sperm production account for the rest of the cases. Surgical sperm retrieval obtains enough sperm, obtains the best quality sperm, and minimizes injury to the testicle and reproductive tract.

A fertility evaluation of both the man and the woman is done prior to the procedure. If the semen analysis shows that you have no sperm or few sperm, other testing, such as a physical exam, will follow. A physician can then determine which kind of sperm retrieval procedure is most suited for you.

Each type of surgical extraction has advantages and disadvantages, and you should consult with your doctor about which type is most suitable for you. The types are as follows:

Microsurgical Epididymal Sperm Aspiration – An incisional is made in the skin of the scrotum. The surgeon is able to see the epididymis through a microscope and fluid is examined for sperm that moves. If moving sperm are seen, the fluid is taken.
Percutaneous Epididymal Sperm Aspiration – This procedure can be done under local anesthesia. A needle is placed in the head of the epididymis. Negative pressure is applied and the white fluid is extracted. This technique is less dependable than the above technique as less sperm is extracted.
Testicular Sperm Extraction – When there is no sperm in the epididymis or there is a sperm production problem, sperm can be directly taken from the testicle. A needle is inserted into the testicle or a tissue sample is taken.