Infertility Treatments
Surgical Sperm Retrieval
Surgical sperm collection, or surgical sperm retrieval, is the collective term for the range of techniques available for the removal of sperm directly from the male reproductive tract.
What is Surgical Sperm Collection?
Sperm are the specialised cells that are produced in the testes that contain the genetic material necessary to fertilise an egg and give rise to a new life.
Surgical Sperm Collection (SSC) is a term that collectively describes the techniques by which sperm are removed from the testicle or epididymis, either being aspirated by a fine needle or a fine incision.
The different kinds of SSC are listed here:
- PESA – percutaneous epididymal sperm aspiration
- TESA – testicular sperm aspiration
- MESA – micro-epididymal sperm aspiration
- TESE – testicular sperm extraction
- MicroTESE – microdissection testicular sperm extraction
How is surgical sperm collection done?
SSC can be done either as an in-patient under general anaesthetic in an operating theatre or as an out-patient under local anaesthetic.
In both settings the sperm can be retrieved from either the testicle or the epididymis. Before the procedure can be done a detailed discussion of the operation must be completed with the treating Doctor and informed consent obtained.
Why is sperm collected surgically?
Surgical sperm collection is recommended when:
- Sperm testing has shown the seminal fluid contains no sperm
- Sperm testing has shown the quality of sperm in semen is very poor
- For use in ICSI following a vasectomy or a failed vasectomy reversal
What are the risks involved with surgical sperm collection?
Failed collection
Your doctor will discuss this risk as it relates to you and together, you will explore your options in the event that no sperm are retrieved. This varies from patient to patient, but may involve a repeat SSC under general anaesthetic or using donated sperm.
Pain
Research has demonstrated that SSC is less painful than a vasectomy and is associated with a quicker recovery to full activity. If required, over the counter oral pain relief should be sufficient.
Dizziness, fainting and nausea
An incomplete nervous block and a nervous reflex causing a sudden drop in blood pressure can sometimes cause this. It is generally transient and easily treated.
Testicular / scrotal haematoma
A small leak from a tiny vessel can collect in the loose tissue of the scrotum and cause painful swelling. In more severe cases, this may require readmission to hospital and surgical drainage. However, most respond to rest, anti-inflammatory drugs and painkillers.
Infection
All surgical procedures have a small risk of infection that would require antibiotic treatment.