Surgical sperm retrieval is a broad term used to describe several types of procedures that can be used to recover sperm directly from the testicles when there is no sperm present in the ejaculate, or what is present is not suitable for fertility treatment. When there is no sperm in the ejaculate, this is called azoospermia. Occasionally, there may be sperm in the ejaculate, but the labs tell the clinicians that what is there is not suitable for injecting into eggs because for example, none of the sperm are moving or are alive.
Surgical sperm retrieval may be a treatment option for men with:
In the first three conditions, sperm are produced by the testes, but are unable to be ejaculated because of the blockage or absence of the vas deferens. The man can still ejaculate seminal fluid but this fluid will not contain any sperm. It is possible to collect sperm directly from the epididymis. The operating microscope magnify tissues by up to 20 times so that the best tubules can be selectively taken. One of the main advantages is less damage to the testosterone producing cells in the testis.
Occasionally it may be possible to surgically unblock the tube that carries the sperm during the ejaculation process, although this has a low success rate. In cases of vasectomy surgical correction in the form of vasectomy reversal may offer another treatment to this problem. This is available as self-funded treatment with success rates up to 85%. However, success rates drop as time from the vasectomy increase and drops to less than 70% success rate after 14 years.
In cases of non-obstructive azoospermia (complete absence of sperm) very small amounts of sperm may be produced and can be collected directly from the testes. This is done by performing multiple testicular biopsies at random. In these cases a biopsy will normally be sent to the laboratory for analysis as to the possible cause of the problem.
In men with obstructive azoospermia there is a very high chance of recovering sperm by this method (>90%). In men with non-obstructive azoospermia the chances of recovering sperm is approximately 40%. If we are successful at retrieving sperm the pregnancy rate for this treatment is very similar to that of ICSI with ejaculated sperm.
If a blockage or obstruction is suspected then the following procedures may be used under a Local Anaesthetic:
The above procedures require only a few hours of hospital stay. The material collected will be examined and you will be advised about the quality and whether there are any sperm present. Material with sperm will be frozen and placed in storage for use at a later stage. These specimens are then thawed and used to inject the eggs obtained during IVF treatment using the technique of ICSI. If surgical retrieval of sperm is successful, usually enough sperm is obtained for several cycles of treatment (if required).
Here at Ramsay Health Care, our skilled and experienced surgeons regularly perform surgical sperm retrieval procedures.
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