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.

PESA

If a patient has a diagnosis of obstruction or a 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. This is called 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 the sperm quality is poor, then an open biopsy may need to be performed, a TESE (Testicular sperm extraction).

TESA

Testicular sperm aspiration can also be attempted in men who are obstructed although some Doctors advise that this technique can also be performed in men that have non-obstructive azoospermia. The principle behind this is that a needle is inserted into the testicle and sperm tubules are aspirated, and sperm retrieved from these. Mr Minhas only uses this technique in men who have normal sperm production i.e. have a blockage. He does not advocate this technique in men who have non-obstructive azoospermia, as the microdissection sperm retrieval is the better procedure in terms of sperm retrieval rates.

MESA

Micro epididymal sperm aspiration is where sperm is aspirated directly under vision from the epididymis. This is either performed as a procedure on its own when a PESA has failed and an open procedure needs to be performed, or alternatively it is performed at the time of potential reconstructive surgery where a small incision is made on the very fine sperm tubes or epididymal tubules under a microscope. The sperm can be aspirated and either stored or used at a cycle time for ISCI treatment.

Patient hub

Pregnancy after vasectomy: 6 questions to ask if you’re considering getting a vasectomy reversal

Find out more >

Surgical Sperm Retrieval: What does it mean and when is it useful?

Find out more >

What is penile reconstruction surgery?

Find out more >

Video FAQ’s

Make an enquiry





18 Devonshire Street, Marylebone, London W1G 7AF
+44 (0)20 7224 5089
Open in Google >

Lister Hospital, Chelsea Bridge Rd, London SW1W 8RH
+44 (0)20 7730 7733
Open in Google >

Katie.Fraser@hcahealthcare.co.uk