What is sperm retrieval?

Sperm retrieval is a group of medical procedures used to collect sperm directly from the reproductive tract or testicles when sperm cannot be obtained through ejaculation. It may be considered for selected men with azoospermia, severe male infertility, or certain reproductive tract problems, and retrieved sperm can be used with assisted reproductive techniques such as ICSI when appropriate.

Sperm retrieval can provide a treatment option for men who have sperm production but are unable to release sperm in the semen, as well as selected men with severely impaired sperm production.

The appropriate technique depends mainly on why sperm are absent from the semen.

When is sperm retrieval needed?

Sperm retrieval may be considered when:

• No sperm are found in the semen (azoospermia).
• There is a blockage in the reproductive tract.
• Sperm cannot be obtained through ejaculation.
• Sperm production is severely impaired.
• Previous fertility treatment requires surgically retrieved sperm.

Before choosing a procedure, your urologist or andrologist will evaluate the underlying cause.

What are the different sperm retrieval procedures?

Common techniques include:

TESA — Testicular Sperm Aspiration

A fine needle is used to aspirate testicular material that may contain sperm.

TESA may be appropriate in selected cases, particularly when sperm production is expected to be present.

TESE — Testicular Sperm Extraction

A small amount of testicular tissue is surgically removed and examined for viable sperm.

Micro-TESE — Microsurgical Testicular Sperm Extraction

Micro-TESE uses an operating microscope to identify areas of the testicle that may contain sperm-producing tissue.

It is particularly important in selected men with non-obstructive azoospermia, where sperm production may be very limited.

Can sperm retrieval be used for azoospermia?

Yes, in selected cases.

The type of azoospermia is important.

Obstructive azoospermia:
The testicles may produce sperm normally, but a blockage prevents sperm from reaching the semen. Sperm retrieval may be considered, although reconstructive treatment may also be an option in selected patients.

Non-obstructive azoospermia:
Sperm production is significantly impaired. In selected patients, Micro-TESE may be considered to search for areas where sperm production may still be occurring.

What happens after sperm is retrieved?

If viable sperm are identified, they can be processed by the embryology laboratory.

Because surgically retrieved sperm may have limited numbers or reduced motility, they are commonly used with ICSI (Intracytoplasmic Sperm Injection) as part of assisted reproductive treatment when appropriate.

The fertility team coordinates the sperm retrieval procedure with the IVF/ICSI cycle.

Is sperm retrieval always successful?

No. The possibility of retrieving viable sperm depends on factors such as:

• The underlying cause of infertility.
• Whether sperm production is present.
• Type of azoospermia.
• Testicular function.
• Genetic factors.
• Previous treatments.

Your specialist can discuss the expected likelihood of sperm retrieval after evaluating your individual condition.

SCI International Hospital

At SCI International Hospital, New Delhi, Dr. Vishal Dutt Gour, Senior Consultant Urologist and Andrologist, provides specialized evaluation and advanced sperm retrieval procedures for men with azoospermia and severe male infertility. Depending on the underlying cause, he may recommend TESA, TESE, or Micro-TESE and coordinate the retrieved sperm with assisted reproductive treatment when required.