Sperm services may be necessary for some patients, these services include:
Surgical sperm retrieval may be a treatment option for men with:
- An obstruction preventing sperm release, due to injury or infection
- Congenital absence of the vas deferens (men born without the tube that drains the sperm from the testicle)
- Non-obstructive azoospermia – the testicles are producing such low numbers of sperm that they don’t reach the vas.
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. 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.
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.
In cases of non-obstructive azoospermia, very small amounts of sperm may be produced and can be collected directly from the testes. 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%.
PESA (Percutaneous epididymal sperm aspiration) is the collection of sperm through a fine needle directly from the epididymis, where sperm is stored, after it is formed in the testes.
TESA (Testicular Sperm Aspiration) is the collection of sperm from a biopsy or several biopsies from the testicular tissue after making a small incision in the scrotal skin.
Micro TESE for Non Obstructive Azoospermia. This involves the extraction of multiple small testicular specimens taken from different sites in each testicle. This is known as a testicular mapping procedure and is best under-taken using operative magnification.