Sperm Retrieval Procedures

Sperm retrieval procedures are vital for men experiencing infertility and desiring fatherhood. It is the process of acquiring sperm primarily for fertility, through surgical or non surgical means especially when sperm is absent or scarce in semen. Certain male fertility conditions may necessitate the performance of sperm retrieval procedures including:

1. Men with no sperm in their ejaculate; a condition known as azoospermia
2. Those with previous scrotal injury or have had vasectomy
3. Cancer patients
4. Those with genetic or hormonal disorders.

The sperm is retrieved for use in In Vitro Fertility (IVF) or Intracytoplasmic Sperm Injection (ICSI) treatments to improve the chances of conception. Different retrieval techniques as well as the success rates are discussed below.

Types of Sperm Retrieval Techniques 

Sperm may be retrieved directly from the testes or epididymis; the tightly coiled tube connected to the testicles. Certain tests including genetic testing and semen analysis may be used to predict the chances of finding sperm using these retrieval processes. The sperm retrieval procedures vary in complexity depending on individual fertility conditions. They include:

Testicular Sperm Extraction (TESE)

A small incision is made in the testes to check the tubules for sperm presence under local anaesthesia. The procedure may be scheduled or done at the same time as the egg retrieval. Patience may opt to freeze their sperm for future IVF attempts. This procedure has been replaced with Micro TESE for men with sperm production challenges.

Microdissection TESE (Micro-TESE)

Male fertility specialists recommend this procedure to patients with azoospermia or have challenges producing sperm. This procedure is performed under general anaesthesia and is synced with female egg retrieval that is done a day post sperm retrieval. Less testicular tissue is removed making this a safer option.

Percutaneous Epididymal Sperm Aspiration (PESA)

This procedure is ideal for IVF or ICSI for prior vasectomy patients and those who have had scrotal injuries and thus suffer obstructive azoospermia. Like Micro TESE, this procedure is synchronized with female egg retrieval. It is done under local anaesthesia. 

Microsurgical Epididymal Sperm Aspiration (MESA)

This is a microsurgical procedure performed under general anaesthesia for patients with blockage in the epididymis. Larger samples of mature sperm are collected compared to other sperm retrieval techniques. Patients may freeze their sperm for future IVF or ICSI procedures. It is ideal for men who suffer from the absence of a vas deferens. 

Who Needs Sperm Retrieval? 

Sperm retrieval is mainly prescribed for couples trying to conceive but cannot do so naturally. Certain conditions like azoospermia, failed vasectomy reversal and genetic conditions may influence a patient’s decision to opt for sperm retrieval techniques.

Azoospermia

This is a condition where there is no sperm present in the semen. According to a research by Hopkins Medicine, 1 percent of all men have azoospermia and of all infertile men, at least 10 percent have it. A patient with azoospermia will need the assistance of sperm retrieval techniques to facilitate conception. There are two kinds of azoospermia:

• Obstructive azoospermia happens when sperm production is normal but there's a blockage preventing the sperm from being in the ejaculate e.g. due to injury or a previous vasectomy or congenital defects.
• Non obstructive azoospermia on the other hand is when the testicles produce very little sperm due to preexisting health conditions.

Failed Vasectomy Reversal

The process of undoing a vasectomy is called a vasectomy reversal. A successful reversal means that sperm can be present in the ejaculate. Sometimes a vasectomy reversal may fail perhaps due to underlying conditions or a blockage post surgery thus requiring sperm retrieval techniques to aid in conception.

Genetic Conditions 

One of the most common genetic conditions affecting male fertility is Klinefelter Syndrome; a condition where one has an extra X chromosome (XXY instead of XY), leading to challenges in sperm production, smaller testicles and reduced testosterone levels. A majority of men with this condition are infertile due to azoospermia.

How the Procedure Works & Recovery Time 

A male fertility specialist will prescribe sperm retrieval techniques based on individual infertility conditions. Once sperm is retrieved, it is then prepared for assisted reproductive procedures that would best suit the individual. These are outpatient procedures that do not require much time spent in a health facility. A patient will be given antibiotics before and after sperm retrieval to reduce infection risk. Ice packs and pain killers may be prescribed for post surgical pain. A jock strap is also ideal for support. Normally, a patient is able to resume light duties after about 2 days while those with heavy lifting jobs will need at least 10 days after a sperm retrieval surgery.

Success Rates with IVF & ICSI 

IVF and ICSI success rates vary depending on the age of the mother, sperm quality and underlying fertility issues. Certain considerations need to be made for the success of fertilization based on individual needs. Your fertility specialist will be able to look at all factors and advice on the best approach. According to a study by The University of California, Intracytoplasmic Sperm Injection boasts 70 - 80 percent of fertilization rates of all eggs injected whereas the one by Yale Medicine records half a million annual live births achieved through In Vitro Fertilization. 

What to Expect at Fertility Associates of Memphis (FAM)

Establishing the causes of male infertility and the need for sperm retrieval procedures is key in determining the cause of action to increase the likelihood of conception. Although there are different retrieval means, it is not a one size fits all situation. A patient will need to walk the journey of parenthood with a dedicated specialist. 

At FAM, we have dedicated professionals committed to providing personalized care to help you achieve your dream. We offer world class services at competitive prices whether you are paying out of pocket or through insurance cover. With a success rate of over 10,000 babies each year, you are sure to add on to that list through our carefully curated treatment plans specifically made for your needs. Schedule your appointment today and start your success journey too.

FAQs:

What foods improve sperm health?

Sperm quality may be improved through consumption of foods rich in antioxidants, omega 3s, zinc and folic acid such as dark green leafy vegetables, nuts, citrus fruits and fish.

How does smoking and alcohol affect sperm?

Excessive alcohol intake can lower testosterone levels and affect sperm production, while smoking reduces sperm count and motility. 

Does heat exposure really affect sperm?

Yes! Extended exposure to high temperatures from sources such as saunas, hot tubs, and laptops placed on laps may lead to a decrease in sperm production, potentially affecting male fertility.

Can stress impact fertility?

Elevated stress levels lead to a rise in cortisol, a hormone that can reduce testosterone levels and negatively impact sperm production.

What vitamins and supplements help improve sperm?

Studies indicate that Vitamin C, Vitamin D, Zinc, Coenzyme Q10, and Folate play a crucial role in enhancing sperm count and quality.