Surgical Sperm Retrieval
In the past, men who failed to have any sperm present in their semen would not have been able to conceive a biological child. Instead, couples suffering from this type of male factor infertility would have had to rely on a sperm donor in order to conceive a child. Nowadays, though, a variety of techniques exist that can be used to collect sperm directly from the testicles, which can then be used in ICSI.
Getting to the Sperm
Surgical sperm retrieval (SSR) is actually an umbrella term that refers to a variety of different techniques that can be used to obtain sperm from a man. These surgical procedures are designed to help men who have little or no sperm present in their semen, a problem which affects about 10% of infertile men. Because there is very little, if any, sperm in the man’s ejaculate, it is necessary to extract sperm directly from the vas deferens, epididymis or the testicles.
Candidates for SSR
Surgical sperm retrieval is not for every man. In general, those men who are experiencing infertility due to one of the following reasons may be able to use SSR in combination with ICSI and IVF in order to produce a pregnancy:
- Blockage in the vas deferens or epididymis
- Congenital absence of the vas deferens (CAVD)
- Sperm production difficulties
Types of Surgical Sperm Retrieval
There are a variety of methods used to surgically remove sperm from within the genital tract. Which form of SSR is best for you will depend upon the reason why sperm is absent from your ejaculate. Although these methods of retrieving sperm do require a surgical procedure, they are generally classified as being minor procedures and often require no more than local anesthetic and a recovery period of only a few days.
Percutaneous Sperm Aspiration
Percutaneous sperm aspiration (PESA) is often the first course of treatment when no sperm is found in a man’s semen, as it does not require any surgical cuts. It is a fairly short procedure, taking no more than 20 minutes to complete and requires only local anesthetic. During PESA, a needle is inserted through the scrotum into the epididymis and is used to remove the liquid inside. Because doctors are looking to collect between 10 and 20 million sperm, in some cases, multiple aspirations in one or both of the testicles are necessary. Since sperm removed from the epididymis are not fully matured yet, it is necessary to use ICSI to fertilize an egg. Men with CAVD or who have scar tissue in their vas deferens are the most suited to this procedure.