Sperm retrieval surgeries

Sperm retrieval is a method utilised to harvest sperm from the testis for IVF purpose. There are several methods to harvest the sperm ranging from simple aspiration to microsurgical sperm retrieval procedure depending on the semen analysis and underlying testicular dysfunction.

  1. Epididymal sperm aspiration (PESA)

  2. Testicular sperm aspiration (TESA) or biopsy/extraction (TESE)

  3. Microsurgical testicular sperm extraction (microTESE)
     

While PESA is a simpler procedure to perform, if the quality of sperm obtained is poor and unsuitable for IVF treatment, TESE is often carried out to harvest the sperm directly from the testis in order to obtain better sperm. Microsurgical (microdissection) TESE is a complex and time-consuming process performed under microscopic magnification using microscopic surgical tools, to localise viable sperm among the testicular tubules when no sperm is found despite random testicular tissue harvest (TESE). Indeed microsurgical TESE is considered the standard of care in sperm retrieval technology for men with no sperm count and is the last method of ensuring your paternity for assisted reproductive technology (IVF therapy).
 

 

What preparation is required?

Both PESA and TESE can be performed under local anaesthesia. However microsurgical TESE is performed under general anaesthesia and therefore you should have nothing to eat or drink for 6 hours prior to surgery. Regular medications can be taken with a sip of water with the exception of blood thinning agents (eg. warfarin, aspirin, clopidogrel) or non-steroidal anti-inflammatories which need to be stopped for 7-10 days. A mid stream urine (MSU) test is required to ensure the urine is sterile before treatment is undertaken.

What do I need to bring to surgery?

  • Your usual medications

What happens in the operating room?

Your procedure will be performed under local or general anaesthesia depending on the types of surgery and anti-microbial cover will be given.

What are the risks?

Sperm retrieval surgeries when performed by expert surgeon, is considered a safe procedure. Some of the common postoperative complaints include:

  • Pain
  • Swelling
  • Bruising or hematoma
  • Skin irritation or mild infection

What to expect afterwards?

You are usually discharged the same day and you can remove the surgical dressing and shower the next day. You will be discharged with 5-7 days of oral antibiotics. Most men return to normal work after a few days. However you should avoid strenuous physical exertion or sexual activity for 6 weeks.

Follow-up

You will have a follow up appointment with Dr Chung scheduled at 6 weeks postoperatively.