Sperm Retrieval is the process of extracting sperms for fertility purposes. Depending on the cause of sperms absent from the semen, the patient’s wants and surgeon skills, the way of extraction is selected from different ways.
Indication for using Sperm Retrieval
For pregnancy purpose in case of low sperm count or weak ejaculation.
For achieving that, Sperm Retrieval is done from other parts of the reproductive tract plus doing in vitro fertilization (laboratory process, in which a sperm and an egg are combined together for fertilization) and intracytoplasmic sperm injection (laboratory process in which the sperm is injected inside the egg) to get the best result (high pregnancy rate), then the formed embryo is transferred to the maternal uterus.
Testis Sperm Retrieval
Testicular Sperm Extraction (TESE) is done for diagnosis of azoospermia.
The extracted sperms can be used in fresh or frozen (cryopreservation) state.
TESE is often used to diagnose the cause of azoospermia. It can also get enough tissue for sperm extraction. The sperm can be used fresh or frozen (“cryopreserved”).
It can be done in the urologist’s office using a nerve block (anesthetic medication to block the sensation from the tests) or done in a hospital or surgical center, hence surgical cuts in the tests can be made.
Testicular Sperm Aspiration (TESA)
Testicular sperm aspiration ( testicular fine needle aspiration) a technique for taking tissue samples to be used for diagnosis of azoospermia (used sometimes in cases with non-obestructive azoospermia) and sperm collection. It can be performed in the urologist’s clinic using a nerve block medication. For sperm retrieval, a fine needle is inserted through the skin to pull the sperms out without making cuts.
TESA with Mapping
Doing TESA all over the tests through the needles spread throughout the tests is called mapping.
Microsurgical Epididymal Sperm Aspiration (MESA)
A method for sperm retrieval that uses a surgical microscope to collect the sperm from the epididymis tubes. It’s characterised by safety and collection of heathy sperms that can be saved by freezing.
It needs highly skilled micro surgeon and and general anesthesia.
Percutaneous Epididymal Sperm Aspiration (PESA)
A simple and low cost technique best used for obstructive azoospermia, doesn’t use high power microscope and can be done more than one time without surgery with partial or general anesthesia, however sperms may not be collected using this way as a fine needle is attached to the epididymis for gentle fluid removal.
Microsurgical Testicular Sperm Extraction (Micro-TESE)
A surgical procedure exclusive for non obstructive azoospermia performed by microsurgeon in operating room, all testicular tissues are checked as the testicular cover is opened.