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What is surgical sperm retrieval?
Around 10% of infertile men and 1% of all men produce no sperm when they ejaculate – azoospermia is a condition where you produce little or no sperm in your semen. This means traditional fertility treatments won’t be effective; you may want to have your sperm surgically extracted so you can explore other fertility options.
Surgical sperm retrieval (SSR) is a technique for collecting sperm to either be used in assisted conception using intracytoplasmic sperm injection (ICSI), or it can be frozen and stored for future fertility treatment.
In the Assisted Conception Unit at Guy’s Hospital, our expert team supports men facing infertility with fast, thorough testing and clear guidance. We provide personalised insights and recommend the best treatment options to help you confidently move forward on your fertility journey.
Experts in treating male infertility
Fast track your care with:
- fertility treatment plans tailored to you
- world-leading fertility experts
- short-notice appointments, available in as little as 1 week
Who is surgical sperm retrieval for?
Surgical sperm retrieval is offered to men who have azoospermia and are trying to father a child with the help of fertility treatment. It may also be offered in cases of failed vasectomy reversal.
There are 2 types of azoospermia: obstructive azoospermia and non-obstructive azoospermia. Our fertility specialists offer surgical sperm retrieval to men with either type.
Obstructive azoospermia
This is when the testes produce sperm, but it isn’t found in your ejaculate because of a blockage or an absence of the vas deferens (the tube that carries sperm from the epididymis to the urethra during ejaculation).
Non-obstructive azoospermia
Non-obstructive azoospermia is where no sperm is found in your ejaculate either because your testicles are producing very low numbers of sperm or no sperm at all.
If you have been diagnosed with azoospermia and would like to have your sperm retrieved surgically, contact our expert team to book an appointment.
What to expect before surgical sperm retrieval?
When you begin your fertility journey it’s important to speak with a medical professional from the start to determine the best options for you. At the Assisted Conception Unit, our experts in male infertility and female infertility are on hand to guide you every step of the way.
Understanding if there are other possible causes of difficulty conceiving will help our fertility specialists to know if surgical sperm retrieval is your best option.
1. Initial consultation
An opportunity to meet your consultant for the first time – they’ll be leading your care throughout every appointment, scan and treatment cycle working with you to achieve the best outcomes.
During this consultation you’ll be able to:
- discuss medical history
- cover any current medication you’re taking
- have a physical exam so we can get a full picture of your health
2. Fertility investigations
During your initial consultation, your specialist will recommend relevant tests or scans to identify any underlying issues.
- Semen analysis and blood tests for couples and individuals.
- Receive clear insights into your fertility potential.
- Outline next steps for treatment and get a full, costed quote.
3. Tailored treatment plan
If you’re happy to proceed, our dedicated patient pathway coordinators will be able to assist with all relevant paperwork, treatment bookings and payments.
What does surgical sperm retrieval involve?
Our fertility consultants offer 2 types of surgical sperm retrieval:
- percutaneous epididymal sperm aspiration (PESA)
- testicular sperm aspiration (TESA)
Both PESA and TESA can be used in treating obstructive azoospermia, while only TESA can help treat non-obstructive azoospermia. Your fertility specialist will advise you on which procedure is most suitable for you.
PESA
PESA is an outpatient procedure – meaning you can go home on the same day – used to collect sperm from the epididymis (a thin, tightly coiled tube attached to each of the testicles), which stores sperm.
PESA takes about 20 to 30 minutes. Your consultant will begin by injecting a local anaesthetic into your scrotum to numb it. They may also give you sedation to help you stay relaxed throughout the process.
A fine needle is then inserted through the skin of the scrotum and into the epididymis. The fluid in the epididymis is then drawn up the needle (aspirated) before being examined under a microscope to assess your sperm’s quantity and quality.
If the sperm quality is good, your consultant can use them immediately in combination with intracytoplasmic sperm injection (ICSI) to fertilise an egg or you can choose to have your sperm frozen and stored for future fertility treatment.
If they can see no viable sperm, your surgeon will usually need to perform a TESA on another day.
TESA
TESA is an outpatient procedure used to collect sperm directly from the testicles (where sperm is produced).
A TESA is carried out under general anaesthetic either before or on the day that a female partner is undergoing egg collection.
To collect your sperm via TESA, your surgeon will insert a fine needle into your testicle and collect the sperm. They will check the sperm and use them immediately to fertilise an egg.
Micro-TESE
Micro-TESE is a surgical procedure used to extract sperm if you have non-obstructive azoospermia. Under general anaesthetic, the testicle is opened up and examined under a microscope to locate areas that are more likely to contain sperm.
For non-obstructive azoospermia, Micro-TESE is considered the best treatment with the highest sperm retrieval rate. Its targeted approach minimises tissue removal.
Although Micro-TESE is performed under general anaesthetic, you should be able to return home on the same day to continue your recovery.
Emergency surgical sperm retrieval
In some cases, on the day of egg collection in the IVF process, a man may not be able to produce a sperm sample. This can occur for a number of reasons, such as stress, anxiety or a medical issue.
In these situations, a surgeon can perform an emergency surgical sperm retrieval using a fine needle or a small incision to collect sperm directly from the testicle or epididymis.
This procedure is usually carried out under local anaesthetic and, while rare, is a good backup option to prevent the IVF cycle from being cancelled.
To learn more about the procedure of having your sperm retrieved surgically, contact our team of fertility experts for an appointment.
Frequently asked questions (FAQs)
The day before your procedure, you need to remove all the hair on your scrotum with a razor or hair removal cream.
You must fast (have no food or drink) for at least 6-8 hours before the procedure and should also avoid alcohol for at least 24 hours.
On the day of the treatment, bring a tight pair of underpants with you to wear after the procedure, not boxer shorts.
You can leave the hospital around 4 hours after the procedure. You will not be able to drive for 24 hours due to the effects of the anaesthetic, so have someone with you or make taxi arrangements to travel home.
If you have any pain after the procedure, you can take over-the-counter painkillers like paracetamol and ibuprofen.
To reduce the slight risk of bleeding, bruising or infection, you should wear tight-fitting underpants for at least 48 hours, including overnight, from the day of your operation. It can then help to wear a jockstrap each day for around 12 days to protect your scrotum and testes and minimise discomfort.
It’s best to avoid hot baths and have a shower instead, as this will help prevent infection. You should also avoid alcohol, medicines that contain aspirin and strenuous exercise for a few days after the procedure. You should not have sex for 1 week after the procedure to allow for healing.
Benefits of surgical sperm retrieval
Surgical sperm retrieval is an excellent treatment option if you want to conceive a child with the help of fertility treatment, such as IVF or ICSI. This method of sperm retrieval gives patients the chance to have children with their genetic make-up. The other options are to use donor sperm or to adopt – find out more about our treatments using donor eggs, sperm or embryos here.
Success rates for collecting sperm via surgical sperm retrieval are very high. If the sperm is viable our surgeons can use it on the same day to fertilise an egg, or it can be frozen and stored, providing you with options in the future if you and your partner decide to have further fertility treatment.
Find out about our fertility success rates here.
Risks of surgical sperm retrieval
Surgical sperm retrieval is a low-risk procedure, but as with any treatment, there can be complications.
Possible complications of surgical sperm retrieval include:
- bleeding
- haematoma (swelling of testicles with blood in the testicle)
- infection
- pain
- testicular damage and chronic pain (very rare)
Your consultant will answer any questions and discuss the procedure and potential risks before proceeding with the treatment.
Fertility prices and packages
Your fertility journey is personal to you – Surgical sperm retrieval methods vary depending on your individual needs, that’s why your consultant will discuss the most appropriate options for you during your initial consultation.
Our prices provide a general guide – book an appointment and receive a tailored treatment plan along with a clear breakdown of associated costs and next steps.
Locations
Our specialists offer sperm retrieval at the following locations:
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Book a fertility appointment today
Call us on 020 3131 5130 to book your appointment today.
Alternatively, fill in our online enquiry form below and we will get back to you as soon as we can.