Surgical Sperm Retrieval FAQs

Surgical Sperm Retrieval questions

Before you and your partner undergo IVF treatment, Mr Julian Norman-Taylor will carry out a semen analysis as some men have issues producing semen in ejaculate and require Surgical Sperm Retrieval (SSR), a procedure to remove sperm directly from the testis of a male partner for use in IVF or IUI treatments.

Here are some of the common questions asked about surgical sperm retrieval:

When will surgical sperm retrieval be required?

The procedure is usually only needed for the following reasons:

  • The male partner is producing no sperm in his ejaculate, a condition known as azoospermia
  • The male partner is impotent and cannot produce ejaculate

What does SSR involve?

Normally a fine needle will be inserted into the epididymis, which is located next to the testis and some fluid is withdrawn for analysis. This procedure is known as Percutaneous Epididymal Sperm Aspiration or PESA or Micro Epididymal Sperm Aspiration (MESA).

If either of these procedures do not retrieve sperm then a second procedure can be attempted, Testicular Sperm Extraction (TeSE) whereby a biopsy (a small piece of tissue) is taken from the testis for close analysis under a microscope. Dependent on the case, this may require open or closed surgery to retrieve the biopsy and Mr Julian Norman-Taylor will discuss the operation with you in detail, focusing on the procedure that is likely to produce the best results for you.

What is the likelihood of success?

This depends on the reason for the lack of sperm. If the problem is caused by a blockage in the vas deferens, the tube which carries sperm from the testis then there is a relatively good chance of success, of up to 80 per cent. Blockages can occur as the result of a vasectomy, infection or it may simply be that the vas deferens has never developed fully.

The chance of success where there is no blockage and the testis are not producing enough sperm are much lower at 20 to 40 percent dependent on whether any sperm can be located in any part of the tissue. TeSE will be required to locate sperm in this case.

When is the operation carried out in the IVF cycle?

Usually the procedure is carried out at least a week before the rest of the IVF treatments to give time to establish the number and viability of the sperm for implantation. The sperm will normally be frozen until required and there is some risk that the sperm will not survive the thawing process. Assuming healthy sperms can be located, then they are normally implanted using the ICSI method where a single sperm is injected directly into the egg using micromanipulation tools to ensure the best possible chance of success. Frozen sperm will never be as reliable as a fresh sample as damage can occur during the thawing process.

Is the surgical sperm retrieval process painful?

The treatment is normally carried out under a local anaesthetic so is not painful. It is not uncommon, however for there to be some bruising and aching for a few days after the TeSE and MESA procedures. Normal over-the-counter painkillers are sufficient to provide some relief. It’s also advisable to wear tight underwear or specialist scrotal supports to minimise any swelling or light bleeding for a few days.

To learn more about the treatments we offer at Chiltern Fertility or to arrange a consultant with our lead fertility expert, Mr Julian Norman-Taylor, fill in the contact form and one of the team will be in touch.