surgical sperm retrieval pregnancy

Unveiling the Mystery: A Guide to Surgical Sperm Retrieval

One couples story

This is a scan shows a 6 week pregnancy. The black area is the water within the ‘gestational sac’ and the lighter area within the gestational sac is the early 6 week pregnancy or ‘fetus’.

This pregnancy came about following a surgical sperm retrieval and IVF cycle with Mr Dobson. The couple had been trying to conceive for many years but the male partner had been found to have no sperm in his semen analysis.

After a consultation with Mr Dobson, the relevant investigations and tests were arranged, including hormonal and genetic testing, and a surgical sperm retrieval was arranged through the IVF clinic. The surgical sperm retrieval was then performed by Mr Dobson and the sperm retrieved frozen, ready to be used to fertilise his partners eggs once she had undergo her IVF cycle.

After a successful first cycle of IVF to collect his partners eggs, his frozen sperm was thawed and the eggs fertilised with intracytoplasmic sperm injection (ICSI). Following this a successful embryo transfer was performed. The couple are now delighted to be 6 weeks pregnant.

What is a Surgical Sperm Retrieval?

Navigating the world of fertility treatments can be overwhelming, especially when faced with the prospect of surgical sperm retrieval.

A surgical sperm retrieval (SSR) is a medical procedure designed to collect sperm directly from the male reproductive system in cases where natural sperm collection through masturbation is challenging, or not possible. This technique becomes crucial for individuals facing male infertility issues, such as obstructive azoospermia, where sperm production in the testicles is normal, but a blockage somewhere between the testicle and penis prevents their release.

A Surgical sperm retrieval can involve several steps and is usually performed under sedation and/ or with local anaesthetic within an IVF unit. There can be several steps to the procedure:

  • Percutaneous Epididymal Sperm Aspiration (PESA): A PESA, is often the first step in an SSR. Sperm is aspirated directly through the scrotal skin with a needle from a structure on the outside of the testicle called the epididymis. The aspirated fluid is then given immediately to the embryologists to examine under a microscope, to find the sperm. If sperm are found, they are frozen and the procedure may end at this point.
  • Testicular Sperm Aspiration (TESA): If sperm are not obtained following the PESA procedure, a TESA may be performed. A TESA involves obtaining sperm directly from the testicles using a small hollow needle to collect tubules from within the testicles. Any tubules and fluid collected are again immediately examined by the embryologists to find sperm.
  • Testicular Sperm Extraction (TESE): If no healthy sperm have been found during the PESA or TESA procedures, a TESE may be performed. This involves making a small incision in the scrotal skin and testicle itself to extract more tubules than is possible with a TESA. Any tubules collected are examined as above. Once sufficient tubules have been extracted, the small incisions are closed using dissolvable sutures.
  • Microscopic TESE (Micro-TESE): For men who have not had success with any of the above procedures, the next step is to make a larger incision in the testicle to examine the inside with a microscope. This allows for targeted biopsies of healthy-looking tubules, increasing the chance of finding healthy sperm. This procedure is only done in a handful of centres in the UK.

Who Might Benefit from SSR?

Fertility treatments such as SSR can allow couples affected by male infertility to have a child together without the need for donor sperm. There are many reasons a man may not be able to produce sperm via masturbation, these include:

  • Genetic conditions such as Cystic fibrosis, conditions affecting the male ‘Y chromosome’ such as ‘AZF microdeletions’ and Klinefelter’s syndrome (47 XXY)
  • Drugs and Medication such as body building (anabolic) steroid use, certain prescribed or illicit medications and chemotherapy.
  • Medical conditions such as diabetes, spinal cord injury or erectile dysfunction

Finally

Surgical sperm retrieval can be a crucial step in overcoming specific male fertility challenges, providing hope for individuals and couples striving to build their families but who are struggling with male infertility.

By discussing the procedure in more detail above, we hope to empower those seeking information on this aspect of fertility care. For personalised advice and tailored care, consult with an experienced fertility specialist such as Mr Sam Dobson, to ensure you receive the very best advice.

To arrange an initial fertility consultation with us, please call 0115 966 2111 or email Mandy Banbury (PA to Mr Dobson) on mandy.banbury@circlehealthgroup.co.uk.