Sperm Retrieval Procedures: What You Need to Know About TESE, PESA, and Micro-TESE

Sperm retrieval procedures are conducted as a precursor to fertility treatment, where a man’s sperm parameters are severe. Low sperm parameters prevent men from reproducing offspring naturally, and are caused by different factors such as health, medical history and even genetic conditions. Sperm retrieval can be done in several ways and are used for different fertility procedures which are determined on a case by case basis. This discussion is about the types of retrieval procedures, the conditions necessary for retrieval, and how retrieved sperm is used in fertility treatments. 

Types of Sperm Retrieval Techniques

Sperm retrieval techniques are determined by the extent of infertility the technique seeks to remedy. As well, if the patient has a partner who will be carrying the pregnancy to term, the procedures are usually coordinated with their partner’s egg retrieval procedure.

Testicular Sperm Extraction (TESE)

When a man does not have sperm in their ejaculate, their sperm could be retrieved directly from their testicular tissue. The surgery is typically done under local or full sedation.

Microdissection Testicular Sperm Extraction (Micro-TESE)

This procedure while similar to the TESE is more advanced, allowing for a more optimal retrieval as it is done using a surgical microscope.

Percutaneous Epididymal Sperm Aspiration (PESA): 

When blockage prevents sperm from exiting through ejaculation, a PESA retrieval procedure can be done whereby the sperm is retrieved from the epididymis. 

Microsurgical Epididymal Sperm Aspiration (MESA)

This is a procedure that is very effective in sperm retrieval, a larger quantity of mature sperm can be retrieved. It is performed when there is obstruction in the tubes which transport sperm or semen resulting in a man’s ejaculate lacking sperm. 

Who Needs Sperm Retrieval? 

There are several reasons why a man who wants to build a family would require sperm retrieval to do so:

Azoospermia

Azoospermia is a condition whereby a man does not produce any sperm in their semen when they ejaculate. There are two types of azoospermia:

Non-obstructive azoospermia

This occurs when hormonal production is low, preventing the efficient production of sperm. In this case, sometimes the genital tract and testicles are healthy, while other times, the testes are poorly developed or have an abnormality that prevents sperm production from occurring. 

Obstructive azoospermia 

This occurs when the genital tract is blocked or obstructed, even when the testicles are in perfect health. Blockage can be as a result of infection or vasectomy. 

Failed Vasectomy Reversal

Vasectomies are a surgical blocking of the genital tract that are typically reversible. However there are times when the procedure to reverse a vasectomy is not successful and this could cause a more permanent blockage of the genital tract. 

Genetic Conditions

In some cases, azoospermia can be caused by genetic disorders. Genetic testing is vital to understanding the root cause of such a case of azoospermia, but it is also key in preventing the passing on of hereditary conditions to the offspring. 

How the Procedure Works and Recovery Time

Sperm mapping is a minimally invasive procedure used to locate where the most sperm can be retrieved from, prior to sperm retrieval. It is used to help fertility experts to determine ideal locations for sperm retrieval procedures. Usually sperm is retrieved from the epididymis, the vas deferens, the ejaculatory tract, or the testicles.

Following the procedure, there may be bruising, swelling, or some discomfort and it usually takes a few days to a week for a patient to recover. Therefore rest, avoiding activities such as driving, sex, or exercise is recommended in order to make a full recovery.  

Success Rates with IVF & ICSI

Sperm retrieval procedures have been successfully combined with assisted reproductive technologies (ART) to help people achieve their family building goals. When comparing the success rates between IVF and ICSI, IVF with ICSI has been more successful than normal IVF because fertilization is done by injecting sperm directly into the cytoplasm of the egg. The success of ICSI has led to the increase of its general use with people undergoing IVF, even when male infertility is not a factor.

What to Expect at Dallas Fertility Center

One can expect expertise, the application of the latest technologies in diagnostics and treatments, personalized treatment plans, and the support of a dedicated team throughout your fertility journey at the Utah Fertility Center. Contact us today for more information. 

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