Surgical Sperm Retrieval: PESA, TESE, and MicroTESE

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What Is Surgical Sperm Retrieval?

Surgical sperm retrieval refers to procedures used to obtain sperm directly from the male reproductive tract in cases where sperm is absent from the ejaculate (azoospermia) or in rare cases where the husband cannot produce on the day of IVF treatment. These techniques are typically performed for men with obstructive or non-obstructive azoospermia and allow them to pursue parenthood through IVF.

At Almond Blossoms, we offer the following surgical sperm retrieval methods:

  • PESA (Percutaneous Epididymal Sperm Aspiration)
  • TESE (Testicular Sperm Extraction)
  • MicroTESE (Microsurgical Testicular Sperm Extraction)

All procedures are performed by cared urologists under local or general anesthesia, depending on the method and case complexity.

When Is Surgical Sperm Retrieval Recommended?

Surgical sperm retrieval is considered in the following situations

Obstructive azoospermia (e.g. vasectomy, congenital absence of the vas deferens).

Non-obstructive azoospermia (poor sperm production within the testes).

Prior unsuccessful ejaculation-based sperm retrieval.

Retrograde ejaculation or ejaculation disorders.

Procedure Types

PESA (Percutaneous Epididymal Sperm Aspiration)

  • A needle is inserted into the epididymis (a small structure behind the testis) to aspirate sperm.
  • Less invasive and often used for men with obstructive azoospermia

TESE (Testicular Sperm Extraction)

  • A small incision is made in the testis to extract a sample of testicular tissue.
  • Sperm are isolated from the tissue in the laboratory.
  • Suitable for obstructive and selected non-obstructive cases.

MicroTESE (Microsurgical Testicular Sperm Extraction)

  • A more advanced technique performed under an operating microscope.
  • Enables targeted extraction of seminiferous tubules likely to contain sperm.
  • Recommended in non-obstructive azoospermia, especially when previous TESE failed.

What Happens to the Retrieved Sperm?

If viable sperm are found:

  • They may be used fresh on the same day as egg collection for ICSI (Intracytoplasmic Sperm Injection).
  • They can also be cryopreserved (frozen) for future use.
  • In some cases, both options are used to preserve fertility flexibility.

Note: Only ICSI (Intracytoplasmic Sperm Injection) can be performed using surgically retrieved sperm, as their number and motility are typically insufficient for conventional IVF or IUI.

Considerations and Risks

There is no guarantee that sperm will be retrieved.

Minor post-operative discomfort or swelling may occur.

MicroTESE may help in selected challenging cases.

Risks are generally low but include infection, bleeding, or testicular damage (rare).

Next Steps

Your fertility specialist at Almond Blossoms will guide you on whether surgical sperm retrieval is appropriate in your case and recommend the most suitable technique.

If you have further questions or would like to book a consultation, please contact our clinic. We are here to support you with clarity, care, and clinical care.

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