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Testicular sperm retrieval

Testicular sperm retrieval is a way to obtain sperm directly from the testicle or its surrounding structures for use in IVF or ICSI.

When is it needed?

Testicular sperm retrieval is most commonly used for men who have azoospermia, i.e. a complete absence of sperm in their semen sample.

There are many reasons why this might be the case. We seek to identify the cause prior to IVF, so that we can offer the most effective treatment for you. Causes may include:

  • Previous vasectomy
  • Congenital absence of the vas deferens, often due to cystic fibrosis
  • Genetic conditions, such as Klinefelter syndrome or Y chromosome microdeletion
  • Partial failure of testicular development.

Sometimes testicular sperm retrieval is also used if sperm found in the semen sample is of a poor quality, or has not led to optimal egg fertilisation or embryo development previously.

How is testicular sperm retrieval performed?

Testicular sperm retrieval is always performed in an operating theatre.  The various techniques are listed below, but all require an anaesthetic – either local anaesthetic (an injection into the scrotum to numb the testicle) or general anaesthetic.

  • Percutaneous epididymal sperm aspiration (PESA) – a fine needle is placed into the epididymis. Suction is then applied to extract the fluid and any sperm it contains; no testicular tissue is collected (performed under local or general anaesthetic)
  • Testicular sperm aspiration (TESA) – a fine needle is placed directly into the testis, suction is applied and the seminiferous tubules (containing testicular tissue) are aspirated from the testis (performed under local or general anaesthetic)
  • Testicular sperm extraction (TESE) – an open biopsy; an incision is made into the scrotum to reveal the testis then some of the seminiferous tubules are excised (performed under general anaesthesia; requires sutures)
  • Microsurgical testicular sperm extraction (Micro-TESE) – an open biopsy as per a TESE; however, a microscope is used to explore the whole testis. The most viable-looking tissue is then sampled (performed under general anaesthetic).

The tissue or fluid obtained from these procedures is immediately transported to Newlife IVF’s on-site lab, so our scientists can prepare any sperm that has been retrieved for egg fertilisation or vitrification (freezing) in a timely manner.

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