Sperm Retrieval

Achieving Pregnancy after Sperm Retrieval

Sperm retrieved from organs in the reproductive tract are not considered fully mature or fertilizable. They may be fine genetically, but they have not learned how to move, find an egg or meet and penetrate the egg. Those processes are learned as the sperm pass through the organs of the reproductive tract. Because the sperm is not fully mature, assisted reproduction through intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is needed to result in pregnancy.

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Sperm Retrieval Techniques

Among the available sperm retrieval techniques, it is difficult to determine which is “best.” The procedure Dr. Turek suggests to you will depend on the sperm sources available and your personal desires and preferences. He will discuss your options at length and help you decide on the approach with which you are most comfortable.

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Vasal Sperm Aspiration (PVSA, MVSA)

Vasal sperm aspiration collects sperm from the vas deferens, the sperm duct where the most mature or fertilizable sperm is found. Sperm in the vas deferens has already passed through the epididymis, which helps with their maturation. Using this technique, pregnancy may be achieved with IUI. This technique may be suggested to you if you have an obstruction in the reproductive tract near the prostate, or you cannot ejaculate due to diabetes or spinal cord injury. The short, same-day procedure is performed under local anesthesia (often with IV sedation). Dr. Turek creates a small puncture in the scrotum and identifies the vas deferens. Liquid is taken from the vas deferens and inspected by an andrology laboratory for sperm. After obtaining a suitable amount of sperm, the vas deferens is closed with microscopic sutures. The recovery period lasts about 24 hours. Complications are extremely rare.

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Epididymal Sperm Aspiration (MESA, PESA)

If the vas deferens is absent or scarred, sperm can be retrieved from the epididymis. Because sperm taken from the epididymis are not as mature as vasal sperm that have traveled through the epididymis, IVF or ICSI is required to achieve pregnancy. Like vasal sperm aspiration, epididymal sperm aspiration is a short, in-office procedure performed under local anesthesia (often with IV sedation). In microscopic epididymal sperm aspiration (MESA), a microscope is used to help find sperm in individual epididymal tubules. With percutaneous epididymal sperm aspiration (PESA), sperm are aspirated blindly from the epididymis through the skin. Like vasal sperm aspiration, the recovery period of epididymal sperm aspiration is about 24 hours.

Testicular Sperm Retrieval (TESA, TESE, MicroTESE)

Sperm retrieved from the testicles is less mature than sperm retrieved with the other methods. Therefore, IVF and ICSI is needed to achieve pregnancy. Sperm can be retrieved from the testicles with needle aspiration (TESA) or percutaneous or open surgical biopsy (TESE). Dr. Turek prefers to remove a small amount of testis tissue non-surgically through a small needle, or by an open surgical biopsy if needed. This tissue is processed by an andrology lab for sperm. Both approaches are same-day procedures performed in our office with local anesthesia (with or without IV sedation). Depending on the approach, full activity can be resumed in 24 to 48 hours. Table 2. Motility of retrieved sperm from the vas deferens, epididymis and testis in Dr. Turek’s study.

Streamlining the Testicular Sperm Retrieval Procedure

Amidst concerns about the invasiveness of biopsies and the risk of permanently injuring the testis, Dr. Turek invented the technique. During a 45 minute in-office procedure, Dr. Turek can learn whether sperm are present in the testes, where they are, and how much sperm is present. This information is used to create a “map” that guides testicular sperm retrieval. Thanks to sperm mapping, fewer and smaller biopsies are required to harvest enough sperm to be used for IVF or ICSI. More importantly, Dr. Turek’s sperm mapping technique has produced more success than other techniques. Published studies have found that sperm mapping found sperm in up to 45% of men who previously came up empty with TESE procedures and one in three men who failed with microTESE procedures. That offers significant hope to men who believed they were out of options.

Contact The Turek Clinic

It’s no wonder that Dr. Turek is called the “Sperm Whisperer” by colleagues in the field. If you have viable sperm somewhere in your reproductive tract, Dr. Turek will identify it and safely procure it to be used with IUI, IVF or ICSI. To schedule a consultation with Dr. Turek, please contact The Turek Clinic today.