Testicular sperm extraction, or sperm retrieval, is an advanced microsurgical technique used to harvest sperm in cases of male factor infertility where there is little or no sperm present in the ejaculate.
Sperm retrieval is a minimally invasive procedure that has proven effective at obtaining viable sperm for use in IVF (in vitro fertilization). The fertility urology specialists affiliated with MRM have extensive experience in extracting sperm. In fact, sperm retrieval after vasectomy and even after chemotherapy is now being performed on a routine basis.
PESA or MESA (microsurgical epididymal sperm aspiration) If there is sperm in the epididymis, either PESA (percutaneous epididymal sperm aspiration) or MESA (microsurgical epididymal sperm aspiration) is preferred as a sperm retrieval method. Under local anesthesia, PESA is the most minimally invasive procedure with a needle passing through the scrotal skin directly into the epididymus from which sperm is quickly drawn up. MESA is more involved and includes a small incision is made in the scrotum. A micropuncture pipette quickly and accurately punctures the epididymal tubule, and the sperm is aspirated through the pipette. The sperm is examined under a microscope for viability, and the incision is closed.
TESE (testicular sperm extraction) For men with little or no sperm in the epididymis, or if there is no epididymis, sperm can be retrieved directly from the testicles. Performed under either local anesthesia or IV conscious sedation (sleeping and breathing on your own), a sliver of testicular tissue is microdissected under an operating microscope. The procedure takes only a few minutes and causes very little post-operative pain or discomfort. Pregnancy success rates are similar to those achieved with epididymal sperm. Any excess sperm from either epididymal extraction (MESA) or testicular extraction (TESE) can be cryopreserved (MRM’s fertility specialists are experts in sperm freezing) for use later, although sperm from these sources exhibit greater sensitivity to freezing than ejaculated sperm. Therefore, patients may sometimes require a second TESE or MESA procedure in case no sperm are viable upon thawing.