For men who have little or no sperm in their ejaculate, the idea that biological fatherhood might still be possible can come as a genuine surprise. Surgical sperm retrieval makes this possible by retrieving sperm directly from the testicles, bypassing the issue entirely.
Surgical sperm retrieval is the collective term for techniques used to remove sperm directly from the testicle when sperm is not present in the ejaculate. It is recommended for men with azoospermia, which can be caused either by a blockage in the sperm transport system or by a problem with sperm production itself.
The procedure is performed under either local anaesthetic or sedation in a day surgery setting. Recovery depends on the technique used, but most men are able to return to work the following day.
Not all patients are suitable for surgical sperm retrieval, as sperm can only be obtained if the testicle is producing it. Before proceeding, Dr Rozen performs investigations to help predict the likelihood of a successful retrieval, which may include hormone tests, physical examination, and genetic testing.
This technique involves a fine needle being passed into the testicle to remove very small pieces of testicular tissue, which are then checked in the laboratory by an embryologist for the presence of sperm. Dr Rozen performs TESA directly and has significant experience with this technique.
This technique involves a small incision in the testicle and the removal of a small sample of testicular tissue, which is then checked by an embryologist for sperm. This procedure is performed by specialist urologists using a high-powered microscope. Dr Rozen works directly with those urologists to coordinate care for her patients.
Sperm retrieved through TESA or TESE can be used in an IVF cycle with a technique called ICSI, where a single sperm is injected directly into an egg. For men who were told conception wasn’t possible, this opens a genuine pathway to biological fatherhood.
If the retrieval is performed on the same day as egg collection, the sperm will be used to attempt fertilisation straight away. If enough viable sperm are collected, the sample can also be frozen for future IVF cycles, meaning the procedure may not need to be repeated. If no viable sperm are found, that outcome is not the end of the conversation. Dr Rozen will discuss all available pathways, including the potential use of donor sperm.
“For men who’ve been told there’s no sperm in their ejaculate, surgical retrieval can be a genuine turning point. It’s an area I find deeply rewarding, because of the difference it can make to a couple’s path forward.”
– Dr Genia Rozen, Fertility Specialist, Genea Melbourne City and Frankston
