Surgical Sperm Retrieval (SSR)

If tests results from fertility screening show that the infertility problem lies with the male partner, surgical sperm retrieval may be proposed.

This is an outpatient procedure to obtain sperm from men unable to produce sperm for any reason. The sperm is then utilised for assisted conception (IUI or IVF/ICSI). We offer three forms of surgical sperm retrieval: 

EPIDIDYMAL SPERM ASPIRATION (PESA)

With the patient under local/general/sedation anaesthesia, we insert a needle into the bag of sperm around the testis and draw sperm out into the syringe. The sperm is assessed by our embryologist and either used immediately for treatment, or frozen for future use. 

TESTICULAR SPERM EXTRACTION (TESE)

Using local/general anaesthesia, we make a small cut into the testis to remove a small piece of tissue. As with the sperm in PESA, the tissue is processed by our embryologist. Sperm is then extracted from it and either frozen for use in the future, or used immediately for assisted conception, as required. 

SURGICAL SPERM RETRIEVAL (MICRO-TESE)

General anaesthesia is used to put the patient to sleep before we make several small cuts into the testis to remove several small pieces of tissue. The tissues are processed by our embryologist and sperm extracted from them and frozen for future use. 

WHAT CAN GO WRONG?

Like every surgical procedure, SSR carries risks that prospective patients need to be aware of including:

• Risks of anaesthesia – these are thankfully uncommon and relate mostly to unexpected allergic reactions to the drugs used
• Bleeding – there is a small risk of bleeding during and after the procedure but this is usually not severe enough to warrant blood transfusion, or to be life threatening
• Pain – the procedure is associated with moderate pain, so we provide painkillers during the early recovery period
• Scrotal swelling – this occurs sometimes and can be a cause for concern. It usually reflects tissue inflammation during the healing process
• Infection – there is a small risk of infection in the testis afterwards; this usually responds well to antibiotics
• Failure of procedure – we do not always succeed in retrieving sperm from the testis and will advise couples immediately of the success or otherwise of the retrieval attempt 

If the retrieval attempt is unsuccessful, we will go through your options with you. We recognise this can be a stressful process, and we offer professional counselling for you and your partner during this time.