Sperm Retrieval (TESA/PESA/TESE)

Things You Must Know About Sperm Retrieval For IVF

In cases of male infertility, where there is little or no sperm in the semen discharge, sperm retrieval is an advanced microsurgical method used to retrieve sperm. Sperm retrieval for IVF is a painless treatment that has been shown to be efficient in retrieving viable sperm for in vitro fertilization.

The Main Objectives Of Sperm Retrieval

  • In order to obtain sperm of the highest quality,
  • To acquire sufficient sperm for immediate IVF use and/or storage
  • To protect the testicles and the reproductive tract from infection

Three Major Types of Sperm Retrieval

Fertility specialists will identify the most appropriate type of sperm retrieval based on the male partner's sperm analysis and a comprehensive physical assessment. Sperm is taken directly from either the epididymis or the testicles. Because epididymal sperm responds better to cryopreservation, retrieval from the epididymis is preferred whenever possible (freezing). The following are the most typical types of Sperm retrieval for IVF:

  1. Testicular sperm aspiration (TESA)

Men who are having sperm collected for IVF/ICSI will undergo the TESA treatment. TESA sperm retrieval is performed under local anaesthesia in the operating room or office. It is timed to coincide with the egg retrieval of their female spouse. The testicle is pierced with a needle, and tissue and sperm are extracted. Men with obstructive azoospermia (s/p vasectomy) undergo TESA. When TESA fails to provide adequate tissue/sperm, an open testicular biopsy is required.

  1. Percutaneous Epididymal Sperm Aspiration (PESA)

PESA is a treatment used to recover sperm for IVF/ICSI in men who have obstructive azoospermia due to a previous vasectomy or infection. PESA sperm retrieval is performed under local anaesthesia in the operating room or office, and it is timed to coincide with the egg retrieval of their female spouse.

  1. Testicular sperm extraction (TESE)

TESE requires making a small slit in the testis and screening for sperm in the tubules. It is either performed on a scheduled basis or in conjunction with the egg retrieval of their female spouse. TESE sperm retrieval is normally done under anaesthesia in the surgery room, however, it can also be done in the office with only local anaesthesia. During this technique, patients commonly cryopreserve sperm for future IVF/ICSI.

The Timing of Sperm Retrieval

The timing of sperm retrieval for IVF in relation to the in vitro fertilisation cycle is a complicated issue. Harvesting the sperm ahead of time and freezing it until the eggs are extracted helps the couple to make an informed decision about whether or not to pursue IVF, as the chances of finding sperm are usually just 60% or less.

The Use Of Retrieved Sperm in IVF

After being washed and further processed in the IVF lab, the retrieved sperm are injected directly into the partner's eggs via intracytoplasmic sperm injection (ICSI), and the IVF cycle continues normally. Many couples suffering from male factor infertility have had success with IVF through sperm retrieval for IVF techniques. High pregnancy rates have emerged from the refining of microsurgical procedures paired with advances in cryopreservation technologies.