Testicular Sperm Retrieval: Semen Extraction for IVF
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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.

Frequently asked questions

  • Is testicular sperm extraction painful?

    The testicular sperm retrieval procedure is typically performed under local or general anesthesia. Although the level of discomfort experienced during extraction can vary depending on the individual, anaesthetic use makes this procedure well-tolerated for most men.

    After the procedure, you may experience some discomfort and swelling in the area. However, this can usually be managed with pain medication and cold packs.

  • How is sperm collected?

    Several techniques can be used to extract sperm, including:

    • Percutaneous epididymal sperm aspiration (PESA): A small needle is inserted through the skin of the scrotum and into the epididymis (a small tube where sperm are stored) to collect a sample of fluid that contains sperm.
    • Testicular sperm aspiration (TESA): A fine needle is inserted directly into the testis to collect a tissue sample containing sperm.
    • Testicular sperm extraction (TESE): A small incision is made in the testicle and a sample of tissue is removed to collect sperm.
    • Microdissection testicular sperm extraction (Micro-TESE): A high-powered microscope is used to locate and remove small areas of testicular tissue that are more likely to contain sperm.
  • What are the success rates for testicular sperm retrieval?

    Success rates for testicular sperm retrieval vary depending on factors such as the underlying cause of infertility, the expertise of the surgeon and the quality of retrieved sperm. In many cases, enough viable sperm can be retrieved for use in assisted reproductive technologies such as intracytoplasmic injection (ICSI).

  • What happens to the retrieved sperm after testicular sperm retrieval?

    After testicular sperm retrieval, the quality and viability of sperm are evaluated in the laboratory. Healthy sperm can then be used for procedures such as intracytoplasmic sperm injection (ICSI) during IVF to fertilise eggs retrieved from the female partner.

  • Can testicular sperm retrieval be used for fertility preservation?

    Testicular sperm retrieval can be used for fertility preservation in certain situations that may affect fertility, such as before cancer treatment. The retrieved sperm can be frozen (cryopreserved) and stored for future use in assisted reproductive technologies.

  • Is testicular sperm retrieval suitable for everyone with male infertility issues?

    Testicular sperm retrieval is primarily used for men with azoospermia (a complete absence of sperm in semen) or severe oligospermia (fewer sperm cells than normal in semen) due to specific conditions affecting sperm production or transport. The procedure may not be suitable for men with certain genetic conditions or those with severe testicular damage.

  • What is the recovery time after testicular sperm retrieval?

    Recovery time after testicular sperm retrieval is typically minimal, with most men able to resume normal activities within a day or two. However, it is essential to follow the post-operative instructions provided by the surgeon and avoid strenuous activities or heavy lifting for a short period to aid in the healing process.

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Get in touch

For more information or to book an appointment with one of our fertility doctors, please call (03) 8080 8933 or email [email protected]. Fertility appointments can also be booked via our online booking page.

Our three Melbourne clinics are based in Box Hill, Clayton and East Melbourne and are open Monday–Friday: 8:00am–5:00pm. We welcome patients from all over Victoria, as well as those seeking care interstate or internationally. All fertility treatment requiring day surgery or lab access (e.g. egg collection, embryo transfer) will take place at our state-of-the-art treatment centre in Box Hill. Fertility consultations and IVF cycle monitoring can be arranged at all three Melbourne clinics.

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