When a man hears the words that he is infertile and sterile, he may understandably assume that he is out of options for becoming a biological father. In reality, most sterile men have viable sperm in the male reproductive tract that can be used to fertilize an egg.
A sperm retrieval procedure is a process that carefully harvests this sperm so that it can be used to achieve pregnancy with assisted reproductive technology. It is a valuable tool for men with azoospermia (i.e., no sperm in the ejaculate) or who cannot ejaculate at all. Depending on your circumstances it may be used as an alternative to, or in conjunction with corrective surgery to maximise the chances of achieving a successful pregnancy.
The procedure used will depend on the outcome of your tests and the nature of exploration. Testicular Sperm Aspiration (TESA) is a simple procedure to extract some of the substance of one (or preferably both) testes for further analysis (e.g. with Obstructive Azoospermia). At the same time, testicular tissue is frozen so that any sperm present can be subsequently used.
Sperm retrieved from organs in the reproductive tract are not considered fully mature or fertilizable. They may be fine genetically, but they have not learned how to move, find an egg or meet and penetrate the egg. Those processes are learned as the sperm pass through the organs of the reproductive tract. As the sperm is not fully mature, assisted reproduction through intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is needed to result in pregnancy.
Who may be recommended a sperm retrieval?
A sperm retrieval might be recommended for patients that have no sperm in the ejaculate and have had one or more failed IVF cycles. If the lack of sperm is caused by an obstruction this can be a very successful procedure.
There are two reasons why sperm may not be reaching the ejaculate.
- Obstructive azoospermia – the testicles are producing sperm; however, an obstruction is preventing it from reaching the ejaculate
- Non-obstructive azoospermia – this refers to a condition meaning that no (or only a small amount) sperm is produced, therefore meaning there is none in the ejaculate.
This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.