Sperm retrieval Techniques
Sperm retrieval is performed usually either in conjunction with a cycle of ICSI (intracytoplasmic sperm injection), or alternatively may be performed in isolation. Recently Mr Minhas has published on a large series of patients which has shown that fresh sperm has no difference in terms pregnancy rates and live birth rates compared to using frozen sperm (see outcome data). In most instances, however, fresh sperm is used. If a patient has a diagnosis of obstruction or blockage, or those who have had a vasectomy and do not wish to undergo vasectomy reversal, sperm can be retrieved directly from the epididymis, or sperm reservoir. In most cases this can be performed under local anaesthetic where a local anaesthetic block is placed within the sperm cord and sperm is aspirated directly from the epididymis; a percutaneous sperm aspiration or PESA. It is possible to get good quantities of sperm that may also be used for freezing. In some cases where the epididymis is difficult to feel or at the time of the aspiration or the sperm quality is poor, then an open biopsy may need to be performed; a TESE (Testicular sperm extraction).
In men who wish to undergo microsurgical reconstruction a micro-epididymal sperm aspiration or MESA can be performed.
The different types of sperm retrieval are;
- PESA; Percutaneous sperm aspiration
- MESA; micro-epididymal sperm aspiration
- TESE; Testicular sperm extraction