Sperm Retrieval

What is Sperm Retrieval and it’s process?

Under normal conditions, the sperms are produced in the testis, stored in the epididymis and travel through the vas deferens to reach the ejaculatory duct. At ejaculatory duct, the semen released by the seminal vesicles takes the sperms to be ejected from the tip of the penis during ejaculation.

This may not be possible with obstructions preventing sperm release that may be caused by injury or infection or the congenital absence of the vas deferens.

Non-obstructive azoospermia is a condition in which the testicles are producing such low numbers of sperm that they don’t reach the vas. Retrograde ejaculation is the condition in which semen enters the bladder instead of emerging through the penis during orgasm.
These conditions can be rectified by simple sperm retrieval during the pathway of sperm ejaculation.

In cases of non-obstructive azoospermia (complete absence of sperm), very small amounts of sperm may be produced and can be collected directly from the testes with a testicular biopsy. This will be sent to the laboratory for analysis as to the possible cause of the problem.

In men with obstructive azoospermia, there is a very high chance of recovering sperm by this method (>90%). In men with non-obstructive azoospermia, the chances of recovering sperm are approximately 40%. If sperm can be retrieved, the pregnancy rate for this treatment is very similar to that of ICSI with ejaculated sperm.

Techniques

PESA (Percutaneous epididymal sperm aspiration)

is the collection of sperm through a fine needle directly from the epididymis, where sperm is stored, after it is formed in the testes.

TESE (Testicular sperm extraction)

is the collection of sperm from a biopsy or several biopsies from the testicular tissue after making a small incision in the scrotal skin.

Microsurgical epididymal sperm aspiration (MESA):

It is a variation of PESA in which the individual epididymal tubes are isolated by incising the scrotal skin, the tissue is observed under the microscope, and the epididymal fluid is aspirated from areas having maximum sperm density.

These are carried out as a day care procedure requiring only a few hours stay in a hospital. It is carried out under local anesthetic that may be combined with a light general anesthetic.

Once the specimen is obtained, it is checked to make sure that sperms are present. The material collected with sperm will be frozen and place in storage for use at a later stage. These specimens are then thawed and used to inject the eggs obtained during IVF treatment using the technique of ICSI. If surgical retrieval of sperm is successful, usually enough sperm is obtained for several cycles of treatment (if required).

After procedure precautions

You can get back to work within 4-5 days. It is advised to wear the scrotal support for 48 hours to protect the scrotum and testes. The stitches need not be removed; they will dissolve within 14 days.

You may experience mild discomfort which includes pain, tenderness, infection, and cloudy discharge.

Is sperm retrieval successful?

The success of sperm retrieval is possible, but this depends on the procedure and individual situation. Different methods, like Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA), have varying degrees of success. It will be easier to succeed if the testes or epididymis are still producing sperm. However, the chances for successful retrieval decrease when blockages or very low sperm count occur.

What are the side effects of sperm retrieval?

This procedure is relatively safe, although some side effects may be observed. You could experience soreness or bruising where the sperm was aspirated. There's always a chance of infection or even bleeding when the methods are invasive. Most of them are pretty minor and easily dealt with by proper care.

Can you get pregnant after sperm retrieval?

Indeed, pregnancy can occur even after sperm retrieval, especially in cases of ICSI treatments, in which sperm is directly injected into the egg to bypass issues of poor motility of the sperm. In some instances, this is indeed a feasible method that might solve some fertility problems in a woman but again depends on her fertility status and the quality of sperm retrieved.

How is sperm retrieval done?

Sperm retrieval involves different techniques depending on the causes of infertility. Common ones include PESA; here, the sperm is drawn from the epididymis and TESE, where it is directly extracted from the testicles. These procedures can usually be conducted under local anesthesia, except in some instances of light sedation for comfort purposes.

Does sperm injection hurt?

The process of sperm injection during ICSI includes the process of injecting sperm into an egg directly. Usually, this doesn't cause pain in a woman's body since it takes place in the lab in a controlled manner. Still, there is a minor ache during the process of retrieval of the eggs because the local anesthetic numbs the discomfort.

How do doctors retrieve sperm?

Doctors use different methods to retrieve sperm, depending on the patient’s condition. The most common techniques are Testicular Sperm Aspiration (TESA) and Percutaneous Epididymal Sperm Aspiration (PESA). Both are minimally invasive and usually performed under local anesthesia. For more complex cases, like severe blockages or no sperm in the ejaculate, these methods might be necessary. At Apollo Fertility, skilled specialists ensure that sperm retrieval is done with precision and care, using advanced treatments tailored to each patient.

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