Finding out that you have little or no sperm in your semen can be a worrying experience. But for men facing fertility challenges, surgical sperm retrieval (SSR) offers a potential path to parenthood. This guide explains the procedures, what to expect, and how it could help.
Essential Info
• Surgical sperm retrieval (SSR) is used to extract sperm directly from the testicles or epididymis.
• Procedures are performed under local anaesthetic, sedation, or general anaesthetic.
• Retrieved sperm can often be frozen and used in treatments like ICSI (intracytoplasmic sperm injection).
Why Might You Need SSR?
SSR is typically recommended when sperm are absent or unsuitable in your semen sample. Common reasons include:
• Obstruction: Blockages preventing sperm release due to injury, infection, or previous surgery (e.g., vasectomy).
• Congenital Absence of the Vas Deferens: Being born without the tubes that carry sperm from the testicles.
• Non-Obstructive Azoospermia: Extremely low sperm production caused by conditions like radiation exposure, disease, or genetic factors.
If you’re facing one of these issues, your clinic will discuss whether SSR is appropriate for you.
What Happens During SSR?
SSR involves recovering sperm directly from the testicles or the epididymis (a structure at the top of the testicles where sperm mature). There are several techniques available:
1. PESA (Percutaneous Epididymal Sperm Aspiration)
• A fine needle is used to extract sperm directly from the epididymis.
2. TESA (Testicular Sperm Aspiration)
• A small incision is made in the scrotum, and sperm are retrieved using a needle and syringe.
3. TESE (Testicular Sperm Extraction)
• Small biopsies are taken from the testicular tissue to locate and retrieve sperm.
4. MicroTESE (Microsurgical Testicular Sperm Extraction)
• A more advanced procedure where an operating microscope is used to identify and extract the areas of the testicle most likely to produce sperm.
The procedure performed depends on your specific condition. Techniques like MicroTESE are often recommended for non-obstructive azoospermia, as they offer higher success rates by targeting the best areas of sperm production.
Anaesthesia Options:
• Local Anaesthetic: Numbs a small area.
• Sedation: Medication helps you feel relaxed and minimises discomfort.
• General Anaesthetic: You’ll be fully asleep during the procedure.
Recovery times vary from a few days to a few weeks, depending on the method used. Your clinic will provide detailed aftercare guidance.
What Happens After Surgery?
If sperm is successfully retrieved, it’s usually frozen for future use. This is to preserve the sample and ensure it’s available when needed.
In most cases, retrieved sperm is used in a procedure called ICSI (Intracytoplasmic Sperm Injection), the most effective treatment for male infertility. During ICSI:
• A single sperm is injected directly into the centre of an egg using a microscopic needle.
• Once fertilisation occurs, the resulting embryo is transferred to the uterus.
Success Rates and Considerations
Unfortunately, SSR doesn’t guarantee success. The likelihood of retrieving viable sperm varies between 22% and 77%, depending on the underlying condition and the method used. Ask your clinic about their specific success rates for the procedure.
If SSR isn’t successful, your clinic may discuss alternative options such as using donor sperm for fertility treatment. While this can be a difficult decision, many couples find it to be a meaningful and effective way to grow their family.
How to Access SSR
You can arrange SSR through private clinics or potentially access it via the NHS, depending on funding criteria in your area. Speak to your GP or fertility specialist about eligibility for NHS funding, as private procedures can be costly.
Conclusion
Surgical sperm retrieval offers hope to men facing complex fertility challenges. While the process can feel daunting, understanding your options and knowing what to expect can help you take the next step with confidence. If you’re considering SSR, speak to your clinic or GP about your eligibility and treatment plan. For more resources, visit the NHS or HFEA.