How Is Sperm Retrieved for ICSI?

In cases where a man’s semen contains no sperm, the sperm may be retrieved from the testicles directly. This sperm is then used to perform an ICSI procedure. The methods for sperm retrieval depend on the factors causing the absence of sperm in the semen such as:

When there is an Obstruction

In cases where a man has no vas deferens, if he has undergone a vasectomy that cannot be reversed or if there is a blockage in the tubes that transport sperm, one of the following sperm retrieval methods may be used:

Testicular Sperm Aspiration (TESA): This procedure is performed under local anesthesia and involves using a needle to pull out the fluid containing sperm directly from the testicles.

Percutaneous Epididymal Sperm Aspiration (PESA): This is similar to TESA except that the fluid containing sperm is harvested from the epididymis instead of the testicles.

Microsurgical TESA (MESA): This is a surgical way of retrieving sperm that is performed under general anesthesia. It involves the use of operating microscopy to locate tubules in the testis and harvest sperm from there. This is one of the most preferred methods of sperm retrieval for ICSI.

When there is no Obstruction

Testicular Sperm Extraction (TESE): This is a surgical procedure wherein a large amount of testicular tissue is removed from different parts of the testicles. Sperm is then identified and isolated with the help of a microscope.

Microdissection TESE: This is similar to the above method except that the tissue to be removed is firsts elected with the help of a microdissecting microscope. Thus, it limits the damage caused to the testicular structure.