Sperm Retrieval Explained: Techniques, Success Rates, Cost and More
Sperm can be successfully retrieved from men in almost any situation using today's minimally invasive techniques. Sperm retrieval (also known as sperm extraction or sperm aspiration) helps men with a vasectomy, a failed vasectomy reversal, an absence of the vas deferens, or blockages anywhere along the seminal tract (obstructive azoospermia) obtain sperm. Even when the sperm count or quantity is so low it does not make it to the outside world (non-obstructive Azoospermia or NOA), sperm aspiration can help. The four primary sperm retrieval techniques are MESA, PESA, TESE, TESA, and MicroTESE which are often used in conjunction with IVF.
En Español: Recuperación de Esperma
Sperm retrieval is a surgical technique for sperm collection from the male reproductive tract. Some health conditions, such as blocked sperm ducts or procedures such as a vasectomy, prevent sperm from entering the semen and ejaculate, causing male infertility. With the help of sperm extraction techniques, viable sperm can be obtained from the testis or epididymis, and when used together with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), it can help infertile men have children.
There are a few different types of sperm retrieval procedures that can be used depending on your individual situation. Each of these extraction techniques have certain benefits and drawbacks.
Percutaneous Epididymal Sperm Aspiration (PESA) is typically the first choice for sperm retrieval, and is done by inserting a needle through the scrotum into the epididymis to collect a small amount of sperm.
Microscopic Epididymal Sperm Aspiration (MESA) is slightly more invasive technique than PESA and uses microsurgical techniques to collect sperm from the epididymis.
TESE & MicroTESE
Testicular Sperm Extraction (TESE) is done either using a needle or a small incision to collect a small sample of the testis tissue for extraction of sperm. In cases of very low sperm production, a technique known as Microscopic TESE (MicroTESE) is used to collect sperm from the testis.
Watch a video of Dr. Bastuba performing a testicular fine needle aspiration (TFNA).
This video contains graphic content.
Sperm retrieval surgery typically takes about an hour and is done under local or general anesthesia, depending on the specific collection technique used. You will not feel any pain during the surgery. However, if the surgery is done under local anesthesia you may feel some discomfort during the procedure, such as pulling sensation.
Patients typically recover quickly from the sperm extraction surgery. You may feel slight discomfort and tenderness on the scrotum for the first 24 to 48 hours. This can be relieved with prescription or over-the-counter pain medications. Bruising and swelling may also occur, which should subside within the first few days. You should be able to return to your normal activities within three to five days after the surgery, and expect a full recovery within two weeks.
As with any surgery, there is always a possibility you may experience some complications and side effects. These can include discomfort, pain, bruising, bleeding and the risk of infection. The more invasive MESA and MicroTESE sperm retrieval procedures carry a higher risk of side effects and may require an overnight stay in the hospital. You will receive antibiotics to prevent infection, and pain medications to help manage any soreness of the treatment area.
Sperm retrieval surgeries have a high success rate. However, the success rate of the sperm aspiration surgery depends on your individual situation and the underlying cause for the surgery. You need to discuss the specifics of your situation with your doctor, who can give you better idea of the success rate you can expect given your medical history.
Once the sperm is collected, it will be used to fertilize your partner’s egg via IVF. Typically your partner’s eggs are collected the same day your sperm retrieval is performed. The egg is then fertilized in the laboratory with your sperm, and cultured for two to six days before being transferred to your partner’s uterus. In cases of low sperm quality, IVF can be used in conjunction with ICSI, a procedure which injects a single sperm directly into the egg. ICSI can increase the success rate of fertilization in cases of low sperm motility or viability.
Sperm extraction and artificial insemination are not typically done together. Sperm collected directly from the testis or epididymis is not “mature” enough to swim and fertilize the egg. Only if the sperm was extracted from the vas deferens, the sperm may be mature enough for artificial insemination.
After the sperm retrieval procedure, the sperm collected can be frozen and cryopreserved for later use. Sperm banking can help avoid the need for another surgical sperm retrieval process in the future. Many choose to freeze their sperm after a sperm retrieval in case the first cycle of IVF is not successful and to keep their options should they want to father more than one child.
Learn more about finances at Male Fertility & Sexual Medicine Specialists with our current financial incentives and insurance coverage information. Contact us to get specific pricing estimates for sperm retrieval costs and fees.
At our Southern California clinic in San Diego, we specialize in vasectomy reversals and helping patients with male infertility by utilizing a multi-faced treatment approach. We work together with each patient to create a personalized treatment plan.
Nitrous Oxide and the Pro-Nox System
MFS and FCC are introducing the use of nitrous oxide with the Pro-Nox System, a safe and effective analgesic method that has been used in hospitals and medical practices for decades. The system rapidly deploys a 50/50 mix of Oxygen and Nitrous Oxide to help ease a patient's pain and anxiety. This option will now be available for patients undergoing in-office procedural care at MFS and FCC. Learn more about nitrous oxide and the Pro-Nox system today.